Provider Demographics
NPI:1437714425
Name:VISION EYE SURGERY CENTER
Entity Type:Organization
Organization Name:VISION EYE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:812-243-7468
Mailing Address - Street 1:8043 RIVOLI RD UNIT 428
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROKE
Mailing Address - State:GA
Mailing Address - Zip Code:31004-3019
Mailing Address - Country:US
Mailing Address - Phone:812-243-7468
Mailing Address - Fax:
Practice Address - Street 1:4050 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1805
Practice Address - Country:US
Practice Address - Phone:812-243-7468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-05
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery