Provider Demographics
NPI:1629255419
Name:EMORY UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY
Entity Type:Organization
Organization Name:EMORY UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-778-4350
Mailing Address - Street 1:1365 CLIFTON ROAD NE #B3500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-778-4350
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE # B3500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-4350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital