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General NPI Number Information
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NPI Number | 1992777858
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Entity Type | Organization
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Legal Business Name | ISLAND EYE CARE PC
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 315A JOHNNY MERCER BLVD
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City | SAVANNAH
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State | GA
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Zip | 31410
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Country | US
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Telephone | 912-897-4243
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Fax | 912-897-0450
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Provider Business Mailing Address
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Address Line | 315A JOHNNY MERCER BLVD
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City | SAVANNAH
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State | GA
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Zip | 31410
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Country | US
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Telephone | 912-897-4243
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Fax | 912-897-0450
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES G BEISEL
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Credential | OD
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Telephone | 912-897-4243
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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 | GA1199
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | GA1230
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License Number State | GA
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