Provider Demographics
NPI:1346465804
Name:FOCUS EYE CARE INC.
Entity Type:Organization
Organization Name:FOCUS EYE CARE INC.
Other - Org Name:JEFF A STOVALL LL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:STOVALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-697-8610
Mailing Address - Street 1:804 LAKEMERE CRST
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3468
Mailing Address - Country:US
Mailing Address - Phone:770-886-8962
Mailing Address - Fax:678-807-2694
Practice Address - Street 1:1570 OLD ALABAMA RD STE 106
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2108
Practice Address - Country:US
Practice Address - Phone:770-557-0039
Practice Address - Fax:678-623-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty