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Organization

GEORGIA EYE INSTITUTE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORINATOR)
(912) 350-9335
Entity
Organization

Contact information

Practice address
420 GENTILLY PL, STATESBORO, GA 30458-5187
(912) 489-3606
(912) 489-1513
Mailing address
PO BOX 931989, ATLANTA, GA 31193-0001
(912) 489-3606
(912) 489-1513

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
207W00000X
Ophthalmology Physician

Other

Enumeration date
11/30/2006
Last updated
01/11/2008
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