Provider Demographics
NPI:1871829192
Name:OCULOFACIAL PLASTIC SURGEONS OF GEORGIA, LLC
Entity Type:Organization
Organization Name:OCULOFACIAL PLASTIC SURGEONS OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:BERNAT
Authorized Official - Last Name:BAYLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-604-4141
Mailing Address - Street 1:3890 JOHNS CREEK PKWY STE 245
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6697
Mailing Address - Country:US
Mailing Address - Phone:770-604-4141
Mailing Address - Fax:770-604-4140
Practice Address - Street 1:3890 JOHNS CREEK PKWY STE 240
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1286
Practice Address - Country:US
Practice Address - Phone:770-604-4141
Practice Address - Fax:770-604-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty