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NPI Code Detail

MEDICARE: EYE Q VISION CARE

MEDICARE: EYE Q VISION CARE
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
1152W00000XOptometrist02111GA
2152W00000XOptometrist001232GA
3152W00000XOptometristOPT001232GA

General Provider Information

NPI Number : 1205057437
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE Q VISION CARE
Provider Business Mailing Address
First Line : 546 LAKELAND PLAZA
Second Line :
City : CUMMING
State : GA
Zip : 30040-2782
Country : US
Telephone Number : 678-208-2393
Fax Number : 678-208-0851
Provider Business Practice Location Address
First Line : 546 LAKELAND PLAZA
Second Line :
City : CUMMING
State : GA
Zip : 30040-2782
Country : US
Telephone Number : 678-208-2393
Fax Number : 678-208-0851
Authorized Official
Title or Position : PRESIDENT
Name : DR. DWIGHT D BOYD
Credential : O.D.
Telephone Number : 678-208-2393
Provider Enumeration Date : 05/02/2007
Last Update Date : 03/09/2016

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Directions to “EYE Q VISION CARE ” Practice Location

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