Provider Demographics
NPI:1174668024
Name:FIERCE & FIERCE EYE CARE INC
Entity Type:Organization
Organization Name:FIERCE & FIERCE EYE CARE INC
Other - Org Name:EAST COBB EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-642-4001
Mailing Address - Street 1:3960 SHALLOWFORD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5014
Mailing Address - Country:US
Mailing Address - Phone:770-642-4001
Mailing Address - Fax:770-641-1656
Practice Address - Street 1:3960 SHALLOWFORD RD
Practice Address - Street 2:SUITE A
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5014
Practice Address - Country:US
Practice Address - Phone:770-642-4001
Practice Address - Fax:770-641-1656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0669860001Medicare NSC
GA001728Medicare ID - Type Unspecified