=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649102583
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VISION ONE EYE CARE DULUTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2026
-----------------------------------------------------
Last Update Date | 06/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1630 PLEASANT HILL RD STE 120
-----------------------------------------------------
City | DULUTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30096-5899
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-578-7915
-----------------------------------------------------
Fax | 678-688-9005
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1630 PLEASANT HILL RD STE 120
-----------------------------------------------------
City | DULUTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30096-5899
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-578-7915
-----------------------------------------------------
Fax | 678-688-9005
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PHILLIP HUYNH
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 678-578-7915
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------