| NPI | 1124519954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA L DERAY Provider Relations 912-629-5968 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0009X Ophthalmology, Glaucoma Specialist |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |