MEDICARE: SMYRNA EYE GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	740	GA
2	152W00000X	Optometrist	1791	GA

General Provider Information

NPI Number	:	1124199534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMYRNA EYE GROUP, P.C.

Provider Business Mailing Address
First Line	:	4280 E WEST CONNECTOR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-4804
Country	:	US
Telephone Number	:	770-435-4457
Fax Number	:	770-435-4555

Provider Business Practice Location Address
First Line	:	4280 E WEST CONNECTOR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-4804
Country	:	US
Telephone Number	:	704-354-4577
Fax Number	:	770-435-4555

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. JAMES SEAN HARPER
Credential	:	OD
Telephone Number	:	770-435-4457

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	08/28/2024

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