Provider Demographics
NPI:1922124718
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:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-453-9333
Mailing Address - Street 1:111 FIELDSTONE DR
Mailing Address - Street 2:STE 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:STE 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:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0444110001Medicare ID - Type Unspecified