Provider Demographics
NPI:1902406572
Name:OPHTHALMOLOGY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:OPHTHALMOLOGY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASANALI
Authorized Official - Middle Name:V
Authorized Official - Last Name:FATTEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-951-4753
Mailing Address - Street 1:268 FULL CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-8041
Mailing Address - Country:US
Mailing Address - Phone:706-951-4753
Mailing Address - Fax:706-210-0771
Practice Address - Street 1:3651 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6426
Practice Address - Country:US
Practice Address - Phone:866-492-9082
Practice Address - Fax:706-651-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Single Specialty