Provider Demographics
NPI:1326178989
Name:LANIER EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LANIER EYE ASSOCIATES, LLC
Other - Org Name:ADVANCED EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-532-0292
Mailing Address - Street 1:625 S ENOTA DR NE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2437
Mailing Address - Country:US
Mailing Address - Phone:770-532-0292
Mailing Address - Fax:770-533-7377
Practice Address - Street 1:625 S ENOTA DR NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2437
Practice Address - Country:US
Practice Address - Phone:770-532-0292
Practice Address - Fax:770-533-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4734970001Medicare NSC