Organization
EYE PHYSICIANS PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES I SUIT M.D. (PRESIDENT)
(478) 743-4666
Entity
Organization
Contact information
Practice address
626 1ST ST, MACON, GA 31201-2805
(478) 743-4666
(478) 743-4740
Mailing address
PO BOX 4687, MACON, GA 31208-4687
(478) 743-4666
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D0264158
CLIA WAIVER #
GA
05
—
300019674C
—
GA
01
—
C30377
RAIL ROAD MEDICARE GRP #
GA
Enumeration date
01/03/2007
Last updated
11/29/2007
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