Takle Eye Surgery Center LLC
NPI #1740776517 in Locust Grove, Georgia
Provider Information
- NPI Number
- 1740776517
- Entity Type
- Organization
- Organization Name
- Takle Eye Surgery Center LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Jul 5, 2018
- Last Updated
- Jul 19, 2021
Practice Location
- Address
- 1075 BANDY PKWY
- Address 2
- STE 105
- City
- Locust Grove
- State
- Georgia
- ZIP Code
- 30248
- Phone
- (770) 228-3836
Authorized Official
- Name
- DR. LEIV M TAKLE JR., MD
- Title
- OWNER
- Phone
- (770) 228-3836
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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