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General NPI Number Information
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NPI Number | 1700171394
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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 | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 285 BOULEVARD NE STE 540
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City | ATLANTA
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State | GA
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Zip | 30312-4214
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Country | US
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Telephone | 404-582-0096
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Fax | 404-589-8920
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Provider Business Mailing Address
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Address Line | 285 BOULEVARD NE STE 540
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City | ATLANTA
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State | GA
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Zip | 30312-4214
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Country | US
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Telephone | 404-582-0096
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Fax | 404-589-8920
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | SUSAN BONNETT
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Credential |
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Telephone | 678-781-7373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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