Organization
SOUTHEASTERN EYE CLINIC PC
Active
Other names
Vision Source - Professional Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
HORACE E DEAL OD (OWNER, PROVIDER)
(912) 764-5609
Entity
Organization
Contact information
Practice address
214 SAVANNAH AVE, STATESBORO, GA 30458-5165
(912) 764-5609
(912) 764-7786
Mailing address
214 SAVANNAH AVE, STATESBORO, GA 30458-5165
(912) 764-5609
(912) 764-7786
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPTO01603
GA
Other
Enumeration date
12/13/2006
Last updated
06/24/2024
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