Provider Demographics
NPI:1588663512
Name:THOMAS EYE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:THOMAS EYE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-781-7388
Mailing Address - Street 1:5995 BARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4411
Mailing Address - Country:US
Mailing Address - Phone:404-705-5757
Mailing Address - Fax:678-781-7324
Practice Address - Street 1:5995 BARFIELD RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4411
Practice Address - Country:US
Practice Address - Phone:404-705-5757
Practice Address - Fax:678-781-7324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-306261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00252405OtherRR MEDICARE
GA011878278AMedicaid
GAP00252405OtherRR MEDICARE
GA111258ASCAMedicare PIN