Organization
LEIV M TAKLE MD PC
Active
Other names
Takle Eye Group
Organization subpart
No
Provider details
NPI number
Authorized official
LEIV M TAKLE JR. MD (OWNER / CEO)
(770) 228-3836
Entity
Organization
Contact information
Practice address
646 S 8TH ST, GRIFFIN, GA 30224-4214
(770) 228-3836
(770) 412-1733
Mailing address
646 S 8TH ST, GRIFFIN, GA 30224-4214
(770) 228-3836
(770) 412-1733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
06/07/2007
Last updated
11/30/2023
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