DR. ELIZABETH IMADE SOBANJO (NPI# 1548313851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548313851 |
| Entity Type | Individual |
| Full Name | DR. ELIZABETH IMADE SOBANJO |
| Credential | O.D |
| Practice Address |
1525 E Park Place Blvd Suite 1800 Stone Mountain GA 30087-3453 |
| Practice Telephone | 7704983434 |
| Practice Fax Number | 7704983440 |
| Mailing Telephone | 7704983434 |
| Mailing Fax Number | 7704983440 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2016-04-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1538 | GA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000900413A | 05 |
| Street Address |
1525 E PARK PLACE BLVD SUITE 1800 |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087-3453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144373267 | Kofi Oteng Gyang | Optometrist | 1525 E Park Place Blvd, #1100, Stone Mountain, GA 30087-3453 | 2007-01-19 |
| 1972036978 | Waterworksnow, Incorporated | Clinic/Center | 1525 E Park Place Blvd, Suite 1800, Stone Mountain, GA 30087-3453 | 2017-04-06 |
| 1306217294 | Reneca Contracting & Consultant | Clinic/Center | 1525 E Park Place Blvd, Suite 300, Stone Mountain, GA 30087-3453 | 2015-10-17 |
| 1558665653 | Godel First Medical Clinics Inc. | Clinic/Center | 1525 E Park Place Blvd, Suite 300, Stone Mountain, GA 30087-3453 | 2011-01-04 |
| 1437484441 | Smiles for Less | Dentist | 1525 E Park Place Blvd, Stone Mountain, GA 30087-3453 | 2009-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| 1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| Find all providers in zip 30087 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144373267 | Kofi Oteng Gyang | Optometrist | 1525 E Park Place Blvd, #1100, Stone Mountain, GA 30087-3453 | 2007-01-19 |
| 1548370620 | Rourger Lynn Johnson | Optometrist | 5615 Memorial Dr Ste G, Stone Mountain, GA 30083-3256 | 2006-08-30 |
| 1831136928 | Alisa Joyce Burnett | Optometrist | 6945 Deer Creek Trce, Stone Mountain, GA 30087-5477 | 2006-05-31 |
| 1881687515 | Michael L Serrano | Optometrist | 5462 Memorial Dr, Suite 101, Stone Mountain, GA 30083-3239 | 2005-08-29 |
| 1346626686 | Robin Mcghee Od PC | Optometrist | 1825 Rockbridge Rd, Stone Mountain, GA 30087-3335 | 2015-08-10 |
| 1407013840 | Mira Kalman Sivan | Optometrist | 5462 Memorial Dr, Suite 101, Stone Mountain, GA 30083-3239 | 2008-05-22 |
| 1164566931 | Robin Mcghee | Optometrist | 1825 Rockbridge Rd, Stone Mountain, GA 30087-3335 | 2007-02-16 |
| 1336215599 | Sharon Kelly Ellis | Optometrist | 5370 Stone Mountain Hwy, Suite 700, Stone Mountain, GA 30087-3581 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850466 | Kelsea Brown | Optometrist | 2184 Henderson Mill Rd Ne Ste 12b, Atlanta, GA 30345-3762 | 2020-10-28 |
| 1437756459 | Atl Optical LLC | Optometrist | 9380 The Landing Dr Ste B, Douglasville, GA 30135-7177 | 2020-10-02 |
| 1831703289 | First Class Eye Care, LLC | Optometrist | 2730 Peachtree Industrial Blvd Ste 206, Duluth, GA 30097-8628 | 2020-09-03 |
| 1770196636 | Orbic Eye Care | Optometrist | 339 Furys Ferry Rd Ste 1, Martinez, GA 30907-3072 | 2020-08-28 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1629680830 | Mobile Medical Eye Care LLC | Optometrist | 110 Moseley Crossing Dr, Stockbridge, GA 30281-6501 | 2020-08-19 |
| 1376154963 | Family First Vision Care Georgia | Optometrist | 1401 Johnson Ferry Rd Ste 148b, Marietta, GA 30062-6499 | 2020-08-17 |
| 1740890284 | Woodstock Eye Associates LLC | Optometrist | 113 Lincoln St, Woodstock, GA 30188-7800 | 2020-08-07 |
| 1770101818 | Tony Lam | Optometrist | 2549 Piedmont Rd Ne Ste 120, Atlanta, GA 30324-3023 | 2020-07-06 |
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
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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.