Marietta Eye Clinic, PA

NPI #1316009616 in Canton, Georgia

Provider Information

NPI Number: 1316009616
Entity Type: Organization
Organization Name: Marietta Eye Clinic, PA
Primary Specialty: Ophthalmology
Enumeration Date: Dec 14, 2006
Last Updated: May 15, 2018

Practice Location

Address: 100 OLD BALL GROUND HWY
City: Canton
State: Georgia
ZIP Code: 30114
Phone: (770) 479-2195

Authorized Official

Name: HENRY ELLIOTT GATEHOUSE
Title: SENIOR DIRECTOR
Phone: (770) 427-8111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Ophthalmology	207W00000X	Primary

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