Organization
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA LEIGH MORELAND (DIRECTOR, REVENUE CYCLE)
(912) 354-4800
Entity
Organization
Contact information
Practice address
420 GENTILLY PL, STATESBORO, GA 30458-5187
(912) 489-3606
(912) 489-1513
Mailing address
4720 WATERS AVE, SAVANNAH, GA 31404-6292
(912) 354-4800
(912) 629-5821
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DAG976
MEDICAID OD
SC
01
—
GAP977
MEDICAID MD
SC
Enumeration date
11/05/2008
Last updated
07/16/2025
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