Provider Demographics
NPI:1568596500
Name:DR. BRUCE E. REID AND ASSOCIATES, PC
Entity Type:Organization
Organization Name:DR. BRUCE E. REID AND ASSOCIATES, PC
Other - Org Name:TOWN CENTER EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-421-1734
Mailing Address - Street 1:400 ERNEST W BARRETT PKWY NW
Mailing Address - Street 2:SUITE 297
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4917
Mailing Address - Country:US
Mailing Address - Phone:770-421-1734
Mailing Address - Fax:
Practice Address - Street 1:400 ERNEST W BARRETT PKWY NW
Practice Address - Street 2:SUITE 297
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4917
Practice Address - Country:US
Practice Address - Phone:770-421-1734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1114152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty