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Organization

STONE MOUNTAIN EYE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELIZABETH SOBANJO O.D (PRESIDENT)
(770) 498-3434
Entity
Organization

Contact information

Practice address
1525 E PARK PLACE BLVD STE 1800, STONE MOUNTAIN, GA 30087-6403
(770) 498-3434
(770) 498-3440
Mailing address
1525 E PARK PLACE BLVD STE 1800, STONE MOUNTAIN, GA 30087-6403
(770) 498-3434
(770) 498-3440

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1538
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009004134
GA
Enumeration date
06/11/2008
Last updated
04/28/2016
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