Organization
SOUTHERN EYE EXCELLENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE F BRACK III M.D. (PHYSICIAN)
(770) 987-0733
Entity
Organization
Contact information
Practice address
5900 HILLANDALE DRIVE, SUITE 345, LITHONIA, GA 30058-6803
(770) 987-0733
(770) 987-3978
Mailing address
5900 HILLANDALE DRIVE, SUITE 345, LITHONIA, GA 30058-6803
(770) 987-0733
(770) 987-3978
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
047403
GA
Other
Enumeration date
09/13/2006
Last updated
08/22/2020
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