MEDICARE: ARC VISION 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	OPT002420	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982146247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARC VISION LLC

Provider Business Mailing Address
First Line	:	3176 ESPLANADE CIR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-4221
Country	:	US
Telephone Number	:	770-961-2020
Fax Number	:	770-968-0854

Provider Business Practice Location Address
First Line	:	3176 ESPLANADE CIR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-4221
Country	:	US
Telephone Number	:	770-961-2020
Fax Number	:	770-968-0854

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	COURTNEY WAITERS
Credential	:
Telephone Number	:	770-961-2020

Provider Enumeration Date	:	11/17/2016
Last Update Date	:	11/17/2016

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Directions to “ARC VISION LLC ” Practice Location

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