MEDICARE: ATLANTA EYE ASSOCIATES GROUP LLC

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

General Provider Information

NPI Number	:	1881570174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA EYE ASSOCIATES GROUP LLC

Provider Business Mailing Address
First Line	:	1841 CHAMBLEE TUCKER RD STE 1-4B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-2784
Country	:	US
Telephone Number	:	770-409-8977
Fax Number	:

Provider Business Practice Location Address
First Line	:	1841 CHAMBLEE TUCKER RD STE 1-4B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-2784
Country	:	US
Telephone Number	:	770-409-8977
Fax Number	:	404-393-2672

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KIM RAHARJA
Credential	:	OD
Telephone Number	:	770-409-8977

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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