Provider Demographics
NPI:1023517471
Name:INFOCUS EYE CARE, INC.
Entity type:Organization
Organization Name:INFOCUS EYE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:KOURTNEY
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-251-1421
Mailing Address - Street 1:165 OLIVIA RUN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7614
Mailing Address - Country:US
Mailing Address - Phone:770-942-9827
Mailing Address - Fax:
Practice Address - Street 1:1270 ARBOR PLACE MALL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7105
Practice Address - Country:US
Practice Address - Phone:770-942-9827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INFOCUS EYE CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-12
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty