Provider Demographics
NPI:1164180055
Name:OPHTHALMIC CONNECTIONS
Entity Type:Organization
Organization Name:OPHTHALMIC CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED OPHTHALMIC ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-367-7174
Mailing Address - Street 1:400 W PEACHTREE ST NW UNIT 712
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-3545
Mailing Address - Country:US
Mailing Address - Phone:770-367-7174
Mailing Address - Fax:
Practice Address - Street 1:400 W PEACHTREE ST NW UNIT 712
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-3545
Practice Address - Country:US
Practice Address - Phone:770-367-7174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic AssistantGroup - Single Specialty