Provider Demographics
NPI:1013172238
Name:HELMY, MARC SACHA (OD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:SACHA
Last Name:HELMY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3999 AUSTELL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1100
Mailing Address - Country:US
Mailing Address - Phone:770-941-2323
Mailing Address - Fax:
Practice Address - Street 1:1455 RIVERSTONE PKWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5627
Practice Address - Country:US
Practice Address - Phone:770-479-0123
Practice Address - Fax:770-720-0104
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2829152W00000X
GAOPT002479152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA788583561AMedicaid
GA788583561BMedicaid
GA788583561CMedicaid