MARIETTA EYE CLINIC, PA (NPI# 1063933588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063933588 |
| Entity Type | Organization |
| Organization Name | MARIETTA EYE CLINIC, PA |
| Practice Address |
2990 Eagle Dr Ste 110 Woodstock GA 30189 |
| Mailing Address |
895 Canton Rd Ne Bldg 100 Marietta GA 30060-8935 |
| Practice Telephone | 7704278111 |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | HENRY ELLIOTT GATEHOUSE (SENIOR DIRECTOR) |
| Authorized Official Telephone | 7704278111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1013079375 | Marietta Eye Clinic, Pa | Optometrist | 8841 Hospital Dr, Douglasville, GA 30134 | 2006-12-14 |
| 1447469507 | Marietta Eye Clinic, Pa | Optometrist | 895 Canton Rd Ne, Building 100, Marietta, GA 30060-8934 | 2007-05-22 |
| 1174685481 | Marietta Eye Clinic, Pa | Optometrist | 2520 Windy Hill Rd Se, Suite 206, Marietta, GA 30067 | 2006-12-14 |
| 1982766218 | Marietta Eye Clinic, Pa | Optometrist | 2453 Powder Springs Rd Sw, Bldg 400, Marietta, GA 30064 | 2006-12-14 |
| 1316009616 | Marietta Eye Clinic, Pa | Optometrist | 100 Old Ball Ground Hwy, Canton, GA 30114 | 2006-12-14 |
| 1689736860 | Marietta Eye Clinic, Pa | Optometrist | 3939 Roswell Rd, Suite 100, Marietta, GA 30062 | 2006-12-14 |
| 1205857968 | Marietta Eye Clinic, Pa | Clinic/Center | 895 Canton Rd Ne, Building 200, Suite 300, Marietta, GA 30060 | 2006-07-21 |
| 1255333175 | Marietta Eye Clinic, Pa | Optometrist | 895 Canton Rd Ne, Building 100, Marietta, GA 30060 | 2005-08-11 |
| Street Address |
2990 EAGLE DR STE 110 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336664226 | Marietta Eye Optical Inc | Durable Medical Equipment & Medical Supplies | 2990 Eagle Dr Ste 110, Woodstock, GA 30189-5575 | 2017-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| 1659702884 | Dana Dunlap | Physician Assistant | 8814 Hwy 9, 114, Woodstock, GA 30189 | 2013-12-13 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710287958 | Todd Katz | Ophthalmology | 253 Upper Byrdcliffe Rd, Woodstock, NY 12498-1055 | 2010-10-21 |
| 1538160627 | Michael Kroll | Ophthalmology | 290 Heritage Walk, Suite 102, Woodstock, GA 30188-6402 | 2005-08-10 |
| 1912296005 | Eye Care Physicians and Surgeons PC | Ophthalmology | 755 S Main St, Suite B01, Woodstock, VA 22664-1143 | 2011-03-30 |
| 1770641110 | Jeffrey Kershaw | Ophthalmology | 2000 Lake Ave, Woodstock, IL 60098 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748219 | Athens Eye Consultants LLC | Ophthalmology | 650 Oglethorpe Ave Ste 5, Athens, GA 30606-2216 | 2020-10-21 |
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1255974630 | Thomas Eye Group PC | Ophthalmology | 2240 Hamilton Creek Pkwy Ste 1100, Dacula, GA 30019-4515 | 2019-10-18 |
| 1972151462 | Rahul Assa Sharma | Ophthalmology | Emory Eye Center 1365 Clifton Rd B, Atlanta, GA 30322-0001 | 2019-08-28 |
| 1821589441 | Thomas Eye Group PC | Ophthalmology | 1110 W Peachtree St Nw Ste 860, Atlanta, GA 30309-3609 | 2018-05-21 |
| 1609363878 | Patricia Anne Bentley | Ophthalmology | 4712 Polo Ln Se, Atlanta, GA 30339-5328 | 2018-04-13 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1689038986 | Jonathan Shader | Ophthalmology | 1120 15th St # Ba-2720, Augusta, GA 30912-3983 | 2016-04-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.