Provider Demographics
NPI:1073562922
Name:VISION MEDICAL CONSULTING, P.C.
Entity Type:Organization
Organization Name:VISION MEDICAL CONSULTING, P.C.
Other - Org Name:GEORGIA LONG TERM CARE AND CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:FRINKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-938-1757
Mailing Address - Street 1:PO BOX 13003
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-0003
Mailing Address - Country:US
Mailing Address - Phone:770-938-1757
Mailing Address - Fax:770-938-1759
Practice Address - Street 1:1990 LAKESIDE PKWY
Practice Address - Street 2:SUITE 170
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5884
Practice Address - Country:US
Practice Address - Phone:770-938-1757
Practice Address - Fax:770-938-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7598Medicare ID - Type Unspecified