ATLANTA EYE INTERNATIONAL SURGERY CENTER INC.


Address: 830 W Peachtree St Nw, Suite 101, Atlanta, GA 30308-1129
Phone: 4048816417

ATLANTA EYE INTERNATIONAL SURGERY CENTER INC. (NPI# 1285655464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285655464
Entity Type Organization
Organization Name ATLANTA EYE INTERNATIONAL SURGERY CENTER INC.
Practice Address 830 W Peachtree St Nw
Suite 101
Atlanta
GA 30308-1129
Practice Telephone 4048816417
Practice Fax Number 4048767565
Mailing Telephone 4048816417
Mailing Fax Number 4048767565
Enumeration Date 2006-07-22
Last Update Date 2012-06-21
Authorized Official Name DR. SHELBY RAY WILKES (MEDICAL DIRECTOR)
Authorized Official Telephone 4048816417
Authorized Official Credential M.D.
Is Organization Subpart Y
Parent Organization Name ATLANTA EYE CONSULTANT

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
11-C0001213 GA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
GA BLUE CROSS BLUE SHIELD 001796 01
GA 681158897A 05
GA RAILROAD MEDICARE P00067521 01

Office Location

Street Address 830 W PEACHTREE ST NW
SUITE 101
City ATLANTA
State GA
Zip Code 30308-1129

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376829937 Antonio Rios Crna PC Nurse Anesthetist, Certified Registered 830 W Peachtree St Nw, Atlanta, GA 30308-1129 2011-10-27
1770506479 Shelby Ray Wilkes Specialist 830 W Peachtree St Nw, Suite 100, Atlanta, GA 30308-1129 2006-07-25

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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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Competitor

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City ATLANTA
Zip Code 30308

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Dataset Information

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.

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