Provider Demographics
NPI:1578188306
Name:THE EYE MD
Entity Type:Organization
Organization Name:THE EYE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MEJA
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-691-5176
Mailing Address - Street 1:1359 MILSTEAD RD NE STE 103
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3865
Mailing Address - Country:US
Mailing Address - Phone:770-691-5176
Mailing Address - Fax:
Practice Address - Street 1:1359 MILSTEAD ROAD
Practice Address - Street 2:SUITE #103
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012
Practice Address - Country:US
Practice Address - Phone:678-509-3639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty