Provider Demographics
NPI:1083869937
Name:EYE-SIGHT LASER VISION CENTERS, LLC
Entity Type:Organization
Organization Name:EYE-SIGHT LASER VISION CENTERS, LLC
Other - Org Name:EYESIGHT LASER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:MATZKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-442-9577
Mailing Address - Street 1:3350 PEACHTREE RD NE
Mailing Address - Street 2:SUITE140
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1039
Mailing Address - Country:US
Mailing Address - Phone:404-442-9577
Mailing Address - Fax:
Practice Address - Street 1:3350 PEACHTREE RD NE
Practice Address - Street 2:SUITE140
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1039
Practice Address - Country:US
Practice Address - Phone:404-442-9577
Practice Address - Fax:404-442-9941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA083232LGB174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty