Marietta Eye Clinic, PA

NPI #1881088649 in Hiram, Georgia

Provider Information

NPI Number: 1881088649
Entity Type: Organization
Organization Name: Marietta Eye Clinic, PA
Primary Specialty: Ophthalmology
Enumeration Date: Mar 19, 2015
Last Updated: Mar 19, 2015

Practice Location

Address: 47 HIGHLAND PAVILION CT
Address 2: SUITE 101
City: Hiram
State: Georgia
ZIP Code: 30141
Phone: (770) 427-8111

Authorized Official

Name: ELLIOTT GATEHOUSE
Title: DIRECTOR
Phone: (678) 784-0226

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Ophthalmology	207W00000X	Primary

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