Organization
ST SIMONS EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARA PHELPS O.D. (OWNER)
(912) 230-6468
Entity
Organization
Contact information
Practice address
110 ISLAND PROFESSIONAL PARK, ST. SIMONS ISLAND, GA 31522-2880
(912) 634-3444
Mailing address
110 ISLAND PROFESSIONAL PARK, ST. SIMONS ISLAND, GA 31522-2880
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2311
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41ZCGCV
MEDICARE PROVIDER ID
—
Enumeration date
07/15/2010
Last updated
03/07/2014
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