Provider Demographics
NPI:1336510767
Name:BUFORD OPTICS LLC
Entity Type:Organization
Organization Name:BUFORD OPTICS LLC
Other - Org Name:PEARLE VISION BUFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTROR
Authorized Official - Prefix:
Authorized Official - First Name:FAREED
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-655-0989
Mailing Address - Street 1:3264 BUFORD DR
Mailing Address - Street 2:100-A
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-8764
Mailing Address - Country:US
Mailing Address - Phone:678-730-2365
Mailing Address - Fax:
Practice Address - Street 1:3264 BUFORD DR
Practice Address - Street 2:100-A
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-8764
Practice Address - Country:US
Practice Address - Phone:404-730-2365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty