Optical Shop at Athens Eye Associates, Inc.

NPI #1407094261 in Bogart, Georgia

Provider Information

NPI Number
1407094261
Entity Type
Organization
Organization Name
Optical Shop at Athens Eye Associates, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
ATHENS EYE ASSOCIATES, P.C.
Primary Specialty
Eyewear Supplier
Enumeration Date
Jan 31, 2009
Last Updated
Aug 29, 2012

Practice Location

Address
1080 VEND DR
Address 2
SUITE 100
City
Bogart
State
Georgia
ZIP Code
30622-3051
Phone
(706) 549-7047

Authorized Official

Name
MICHAEL S. JACOBS, M.D.
Title
PRESIDENT
Phone
(706) 549-7047

Specialties & Taxonomy Codes

Specialty
Eyewear Supplier

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