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General NPI Number Information
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NPI Number | 1740338185
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Entity Type | Organization
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Legal Business Name | ALLATOONA EYE INSTITUTE PC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 962 JOE FRANK HARRIS PKWY SE SUITE 201
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2154
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Country | US
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Telephone | 770-382-3598
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Fax |
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Provider Business Mailing Address
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Address Line | 962 JOE FRANK HARRIS PKWY SE SUITE 201
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2154
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Country | US
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Telephone | 770-382-3598
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KIM SMITH
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Credential |
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Telephone | 770-382-3598
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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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