Provider Demographics
NPI:1720040843
Name:FAMILY EYECARE ASSOCIATES OF MILLEDGEVILLE, PC
Entity Type:Organization
Organization Name:FAMILY EYECARE ASSOCIATES OF MILLEDGEVILLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:STEVE
Authorized Official - Last Name:MCQUAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-453-9333
Mailing Address - Street 1:111 FIELDSTONE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7106
Mailing Address - Country:US
Mailing Address - Phone:478-453-9333
Mailing Address - Fax:478-453-7760
Practice Address - Street 1:111 FIELDSTONE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-7106
Practice Address - Country:US
Practice Address - Phone:478-453-9333
Practice Address - Fax:478-453-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA152W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP647Medicare ID - Type Unspecified