| NPI | 1689285819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENELL JACKSON Managing Physician 404-790-7628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2022-02-16 |