Organization
ATHENS RETINA CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAN NARAYANASWAMY IYER M.D. (OWNER)
(706) 543-3200
Entity
Organization
Contact information
Practice address
2705 JEFFERSON RD, ATHENS, GA 30607-1208
(706) 543-3200
(706) 433-1745
Mailing address
2705 JEFFERSON RD, ATHENS, GA 30607-1208
(706) 543-3200
(706) 433-1745
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
059245
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059245
STATE LICENSE
GA
01
—
73361
STATE LICENSE
GA
Enumeration date
05/07/2007
Last updated
05/09/2018
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