Organization
EYECARE ONE MARTINEZ LLC
Active
Other names
Broome Family Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WESLEY BROOME OD (PRESIDENT OWNER)
(706) 863-3030
Entity
Organization
Contact information
Practice address
510 NORTH BELAIR RD, EVANS, GA 30809
(706) 863-3030
(706) 863-0093
Mailing address
510 NORTH BELAIR RD, EVANS, GA 30809
(706) 863-3030
(706) 863-0093
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
848T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52159903
BLUE CROSS BLUE SHIELD
GA
Enumeration date
04/19/2007
Last updated
07/14/2009
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