Provider Demographics
NPI:1518953470
Name:PREMIER EYE CARE ASSOC. PC
Entity Type:Organization
Organization Name:PREMIER EYE CARE ASSOC. PC
Other - Org Name:PREMIER EYECARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SZEKERESH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:706-632-6989
Mailing Address - Street 1:136 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-3102
Mailing Address - Country:US
Mailing Address - Phone:706-745-0567
Mailing Address - Fax:706-745-0556
Practice Address - Street 1:136 HOSPITAL DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3102
Practice Address - Country:US
Practice Address - Phone:706-745-0567
Practice Address - Fax:706-745-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049674207W00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
18BDBKFMedicare PIN
H33375Medicare UPIN
GAGRP6926Medicare ID - Type UnspecifiedMEDICARE