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Organization
PREMIER OPHTHALMOLOGY, LLC
Active
Organization
PREMIER OPHTHALMOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY G JACOBY M.D. (PHYSICIAN OWNER)
(770) 787-6200
Entity
Organization
Contact information
Practice address
7170 HIGHWAY 278 NE, SUITE B, COVINGTON, GA 30014-1529
(770) 787-6200
(770) 787-2643
Mailing address
7170 HIGHWAY 278 NE, SUITE B, COVINGTON, GA 30014-1529
(770) 787-6200
(770) 787-2643
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
6856
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000326697B
—
GA
Enumeration date
01/24/2007
Last updated
08/02/2012
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