Organization
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC
Active
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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