Georgia Eye Institute of the Southeast, LLC

NPI #1154714574 in Vidalia, Georgia

Provider Information

NPI Number: 1154714574
Entity Type: Organization
Organization Name: Georgia Eye Institute of the Southeast, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC
Primary Specialty: Optometrist
Enumeration Date: Mar 10, 2015
Last Updated: Apr 17, 2015

Practice Location

Address: 104 ANDREWS STREET, SUITE 112
City: Vidalia
State: Georgia
ZIP Code: 30474
Phone: (912) 537-4447

Authorized Official

Name: KATHY HEGAN
Title: PRACTICE ADMINISTRARTOR
Phone: (912) 629-5929

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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