Provider Demographics
NPI:1053634808
Name:EXPERT EYE CARE, INC
Entity Type:Organization
Organization Name:EXPERT EYE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:SHIH
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-591-9938
Mailing Address - Street 1:1038 ALYSSUM DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-8124
Mailing Address - Country:US
Mailing Address - Phone:770-591-9938
Mailing Address - Fax:
Practice Address - Street 1:6435 BELLS FERRY RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-2317
Practice Address - Country:US
Practice Address - Phone:770-926-4810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT 002165261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center