Provider Demographics
NPI:1316007701
Name:ROBINS EYE CARE LLC
Entity Type:Organization
Organization Name:ROBINS EYE CARE LLC
Other - Org Name:INDIVIDUAL ANITHA KANNAN OD
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-953-1000
Mailing Address - Street 1:3035 WATSON BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093
Mailing Address - Country:US
Mailing Address - Phone:478-953-1000
Mailing Address - Fax:478-953-1003
Practice Address - Street 1:3035 WATSON BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093
Practice Address - Country:US
Practice Address - Phone:478-953-1000
Practice Address - Fax:478-953-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 1927152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U91669Medicare UPIN
GA41ZCFCWMedicare ID - Type Unspecified