Organization
SUPERIOR EYECARE OF MADISON INC
Active
Other names
Superior Eyecare of Griffin
Organization subpart
No
Provider details
NPI number
Authorized official
MALIQUE R PAYNE OD (OWNER/OPTOMETRIST)
(256) 716-6955
Entity
Organization
Contact information
Practice address
1569 N EXPRESSWAY, GRIFFIN, GA 30223-1746
(770) 233-6860
(770) 233-6825
Mailing address
125 PAVILION PKWY, FAYETTEVILLE, GA 30214-4098
(770) 460-7894
(770) 719-4392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
R-227-TA-984
AL
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003177763A
—
GA
Enumeration date
10/04/2014
Last updated
12/22/2020
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