Provider Demographics
NPI:1710438759
Name:PEACHTREE EYE ASSOCIATES P C
Entity Type:Organization
Organization Name:PEACHTREE EYE ASSOCIATES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:404-816-1519
Mailing Address - Street 1:3393 PEACHTREE RD NE STE B128
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1197
Mailing Address - Country:US
Mailing Address - Phone:404-816-1519
Mailing Address - Fax:404-816-8574
Practice Address - Street 1:3393 PEACHTREE RD NE
Practice Address - Street 2:INSIDE MACY'S
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1162
Practice Address - Country:US
Practice Address - Phone:404-816-1519
Practice Address - Fax:404-816-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT2392152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty