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General NPI Number Information
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NPI Number | 1659858991
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Entity Type | Organization
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Legal Business Name | APEX EYECARE
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 3694 CLUB DRIVE UNIT 101
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044
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Country | US
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Telephone | 678-395-7262
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Fax | 678-395-7344
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Provider Business Mailing Address
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Address Line | P.O.BOX 390693
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City | SNELLVILLE
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State | GA
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Zip | 30039
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Country | US
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Telephone | 678-395-7262
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Fax | 678-395-7344
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | LUKE ESEKHEIGBE
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Credential | O.D.
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Telephone | 678-395-7262
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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 | OPTOO2117
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License Number State | GA
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