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General NPI Number Information
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NPI Number | 1730804030
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Entity Type | Organization
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Legal Business Name | SUMMIT EYE LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 5400 LAUREL SPRINGS PKWY STE 103
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City | SUWANEE
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State | GA
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Zip | 30024-6057
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Country | US
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Telephone | 470-403-2020
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Fax | 470-805-2020
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Provider Business Mailing Address
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Address Line | 5400 LAUREL SPRINGS PKWY STE 103
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City | SUWANEE
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State | GA
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Zip | 30024-6057
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Country | US
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Telephone | 470-403-2020
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Fax | 470-805-2020
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Authorized Official
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Title or Position | MEMBER
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Name | JEFFREY TRAN
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Credential | MD
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Telephone | 706-877-4528
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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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