Organization
GEORGIA RETINA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL LUCAS (CFO)
(404) 255-9096
Entity
Organization
Contact information
Practice address
1100 JOHNSON FERRY RD NE, SUITE 593, ATLANTA, GA 30342-1709
(404) 255-9096
(404) 255-9097
Mailing address
1100 JOHNSON FERRY RD NE, SUITE 593, ATLANTA, GA 30342-1709
(404) 255-9096
(404) 255-9097
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2009
Last updated
04/22/2011
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