SOUTHERN EYE CENTER, PC (NPI# 1316020043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316020043 |
| Entity Type | Organization |
| Organization Name | SOUTHERN EYE CENTER, PC |
| Other Organization Name | SOUTHERN EYE CENTER, PC |
| Practice Address |
2310 N Patterson St Suite B Valdosta GA 31602-2568 |
| Practice Telephone | 2292472020 |
| Practice Fax Number | 2292475600 |
| Mailing Telephone | 2292472020 |
| Mailing Fax Number | 2292475600 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-11-01 |
| Authorized Official Name | DR. MARK JOSEPH EANES SR. (PRESIDENT) |
| Authorized Official Telephone | 2292472020 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | OPT002069 | GA | Eye and Vision Services Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 174400000X | Specialist | 025970 | GA | Other Service Providers |
| Other Name | Type Code |
|---|---|
| SOUTHERN EYE CENTER, PC | Doing Business As Name - Organization |
| Street Address |
2310 N PATTERSON ST SUITE B |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-2568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215938501 | Raymond Derry Crosby | Orthopaedic Surgery | 2310 N Patterson St, Bldg D, Valdosta, GA 31602-2568 | 2005-08-09 |
| 1770951253 | Dustin Goff | Nurse Anesthetist, Certified Registered | 2310 N Patterson St, Suite C, Valdosta, GA 31602-2568 | 2015-09-14 |
| 1891095840 | Karen Alene Bowser | Nurse Practitioner | 2310 N Patterson St, Suite G, Valdosta, GA 31602-2568 | 2010-10-25 |
| 1104134683 | Stephany Ann Norris | Counselor | 2310 N Patterson St, Suite G, Valdosta, GA 31602-2568 | 2010-09-18 |
| 1306090675 | Justin Mark Booth | Anesthesiologist Assistant | 2310 N Patterson St, Bldg C, Valdosta, GA 31602-2568 | 2008-11-12 |
| 1023275757 | Kelly Delayne Jones | Social Worker | 2310 N Patterson St, Suite G, Valdosta, GA 31602-2568 | 2008-05-20 |
| 1134316920 | South Georgia Orthopedics, P.C. | Clinic/Center | 2310 N Patterson St, Bld. D, Valdosta, GA 31602-2568 | 2007-09-26 |
| 1053527945 | Leah Carol Mcmillan | Marriage & Family Therapist | 2310 N Patterson St, Suite G, Valdosta, GA 31602-2568 | 2007-05-15 |
| 1467556944 | Lance Jason Haluka | Optometrist | 2310 N Patterson St, Suite B, Valdosta, GA 31602-2568 | 2006-09-12 |
| 1205947496 | Mark Joseph Eanes | Ophthalmology | 2310 N Patterson St, Suite B, Valdosta, GA 31602-2568 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356767404 | Delilah Byron | Specialist | 4353 Sandy Springs Dr, Valdosta, GA 31605-5492 | 2014-03-13 |
| 1861676892 | Southern Urological Associates | Specialist | 2805 N Oak St, Suite B, Valdosta, GA 31602-5922 | 2007-12-27 |
| 1144404484 | Valdosta Urological Associates | Specialist | 3543 North Crossing Circle, Valdosta, GA 31602 | 2007-12-21 |
| 1265612337 | Barbara J. Williams | Specialist | 2704 N Oak St A2, Valdosta, GA 31602 | 2007-11-06 |
| 1659587301 | Fauzia K. Durrani M.d., PC | Specialist | 107 Woodrow Wilson Dr, Valdosta, GA 31602-2539 | 2007-05-16 |
| 1952431223 | Azalea Center for Plastic Surgery PC | Specialist | 2810 N Oak St, Valdosta, GA 31602-1716 | 2007-03-06 |
| 1326174327 | Steven T. Greenhaw Md PC | Specialist | 2704 N Oak St Bldg G, Valdosta, GA 31602-1767 | 2007-02-26 |
| 1194898288 | Laura D Gwillim | Specialist | 2704 C N Oak St, Valdosta, GA 31602-1781 | 2006-11-16 |
| 1588740609 | Joel P. Hunnicutt | Specialist | 2804 C. N. Oak Street, Valdosta, GA 31602 | 2006-10-31 |
| 1134148208 | Valdosta Anesthesia Associates, P.C. | Specialist | 2310 N Patterson St Bldg C, Valdosta, GA 31602-2500 | 2006-07-19 |
| Find all providers in VALDOSTA | ||||
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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.