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General NPI Number Information
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NPI Number | 1902201254
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Entity Type | Organization
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Legal Business Name | TIPPETT EYECARE, PC
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 701 DEVIKA DR STE 3
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City | GROVETOWN
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State | GA
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Zip | 30813-5137
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Country | US
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Telephone | 762-222-7104
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Fax |
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Provider Business Mailing Address
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Address Line | 2465 WRIGHTSBORO RD
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City | AUGUSTA
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State | GA
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Zip | 30904-6244
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Country | US
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Telephone | 706-738-1102
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANNETTE CARRAWAY
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Credential |
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Telephone | 706-738-1102
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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 | 1296T
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License Number State | GA
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