Provider Demographics
NPI:1174661516
Name:VALLEY VISION CENTER, INC
Entity Type:Organization
Organization Name:VALLEY VISION CENTER, INC
Other - Org Name:ARCHER OPTICAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:COURTRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:706-643-2020
Mailing Address - Street 1:400 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:31833-1522
Mailing Address - Country:US
Mailing Address - Phone:706-643-2020
Mailing Address - Fax:706-643-2022
Practice Address - Street 1:400 3RD AVE
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833-1522
Practice Address - Country:US
Practice Address - Phone:706-643-2020
Practice Address - Fax:706-643-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT000774152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4299500001Medicare NSC