Organization
COASTAL RETINA INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAXMI DEVISETTY MD (PHYSICIAN OWNER)
(312) 451-6220
Entity
Organization
Contact information
Practice address
836 E 65TH ST STE 38, SAVANNAH, GA 31405-4495
(912) 376-2030
Mailing address
16 BALLASTONE CT, SAVANNAH, GA 31410-5129
(312) 451-6220
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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