SOUTHERN EYE CLINIC P.C. (NPI# 1285602672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285602672 |
| Entity Type | Organization |
| Organization Name | SOUTHERN EYE CLINIC P.C. |
| Other Organization Name | SOUTHERN EYE CENTER |
| Practice Address |
1306 Troupe St Augusta GA 30904-4755 |
| Practice Telephone | 7067361437 |
| Practice Fax Number | 7067336414 |
| Mailing Telephone | 7067361437 |
| Mailing Fax Number | 7067336414 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WILLIAM V TILLERY (PRESIDENT) |
| Authorized Official Telephone | 7067361437 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 2006#017184 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southern Eye Center | Doing Business As Name - Organization |
| Street Address |
1306 TROUPE ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447714662 | Ortho Sport & Spine Physicians Augusta | Clinic/Center | 1306 Troupe St, Augusta, GA 30904-4799 | 2019-01-23 |
| 1356824585 | Ortho Sport & Spine Physicians Augusta | Orthopaedic Surgery | 1306 Troupe St, Augusta, GA 30904-4799 | 2018-09-13 |
| 1316080526 | Team Investments | Eyewear Supplier (Equipment, not the service) | 1306 Troupe St, Augusta, GA 30904-4755 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1467814830 | David Jay Felsted | Ophthalmology | 1120 15th St Ste Ba-2701, Augusta, GA 30912-0004 | 2016-03-24 |
| 1194914580 | Margaret O. Green,m.d.,p.c. | Ophthalmology | 1303 Dantignac St Ste 2100, Augusta, GA 30901-2777 | 2007-10-22 |
| 1982816732 | Grene Vision Group LLC | Ophthalmology | 706 E Smiles, Augusta, KS 67010 | 2007-05-04 |
| 1275699639 | Siras Allan Stocks | Ophthalmology | 3535 Stevens Way, Augusta, GA 30907-9564 | 2006-12-29 |
| 1164583944 | James Ace Brown | Ophthalmology | 728 Ravenel Rd, Augusta, GA 30909-4524 | 2006-12-13 |
| 1568475804 | Robert J Thompson | Ophthalmology | 1 Freedom Way # 224, Augusta, GA 30904-6258 | 2006-08-15 |
| 1467418954 | Horizon Eye Center Inc | Ophthalmology | 1212 Augusta West Pkwy, Ste A1, Augusta, GA 30909-1808 | 2006-04-24 |
| 1881660074 | Maroulla Gleaton | Ophthalmology | 227 Eastern Ave, Augusta, ME 04330-5951 | 2006-02-27 |
| Find all providers in AUGUSTA | ||||
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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.