Organization
NORTH GEORGIA VISION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN BRENT CLARK OD (OPTOMETRIST OWNER)
(706) 375-1720
Entity
Organization
Contact information
Practice address
8390 N HIGHWAY 27, ROCK SPRING, GA 30739-2103
(706) 375-1720
(706) 375-1729
Mailing address
8390 N HIGHWAY 27, ROCK SPRING, GA 30739-2103
(706) 375-1720
(706) 375-1729
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD0000002478
TN
152W00000X
Optometrist
Primary
OPT002352
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101846
AVESIS
—
01
—
194699738A
MEDICARE GA
—
05
—
194699738A
—
GA
01
—
205370293
NVA
—
01
—
33901
OPTI CARE
—
01
—
4115539
BCBS
TN
01
—
41ZCGGN
MEDICARE
GA
01
—
41ZCGGN
MEDICARE GA
—
01
—
45460
SPECTERA
—
01
—
59526
DAVIS VISION
—
01
—
911517
EYE MED
—
01
—
927618
BLOCK VISION LOCATION NUMBER 114419
—
Enumeration date
05/23/2008
Last updated
06/08/2021
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