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General NPI Number Information
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NPI Number | 1609530187
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Entity Type | Organization
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Legal Business Name | THOMAS EYE GROUP PC
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 130 PEACHTREE EAST COURT SUITE 120A
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4800
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Country | US
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Telephone | 788-922-0206
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 PEACHTREE DUNWOODY RD STE A500
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City | ATLANTA
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State | GA
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Zip | 30328-7162
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Country | US
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Telephone | 678-781-7373
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PAUL L KAUFMAN
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Credential |
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Telephone | 678-892-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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