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Organization

PROVOST EYE GROUP, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DREW ALEX PROVOST O.D. (PRESIDENT)
(770) 431-1713
Entity
Organization

Contact information

Practice address
2900 CUMBERLAND MALL SE, ATLANTA, GA 30339
(770) 431-1713
(770) 431-1714
Mailing address
2900 CUMBERLAND MALL SE, ATLANTA, GA 30339
(770) 431-1713
(770) 431-1714

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002244
GA

Other

Enumeration date
08/19/2006
Last updated
07/26/2007
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