Provider Demographics
NPI:1093145609
Name:AMK EYECARE, P.C.
Entity Type:Organization
Organization Name:AMK EYECARE, P.C.
Other - Org Name:EYECLECTIC VISION SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KNOUFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-592-5795
Mailing Address - Street 1:2020 HOWELL MILL RD NW
Mailing Address - Street 2:37
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1732
Mailing Address - Country:US
Mailing Address - Phone:404-835-2975
Mailing Address - Fax:404-835-2976
Practice Address - Street 1:2020 HOWELL MILL RD NW
Practice Address - Street 2:37
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-1732
Practice Address - Country:US
Practice Address - Phone:404-835-2975
Practice Address - Fax:404-835-2976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2418152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty