Provider Demographics
NPI:1336277151
Name:GEORGIA EYE CARE CENTER INC
Entity Type:Organization
Organization Name:GEORGIA EYE CARE CENTER INC
Other - Org Name:FELICITY A QUANSAH MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICITY
Authorized Official - Middle Name:ARABA
Authorized Official - Last Name:QUANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-743-2000
Mailing Address - Street 1:1870 HARDEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1161
Mailing Address - Country:US
Mailing Address - Phone:478-743-2000
Mailing Address - Fax:478-743-0096
Practice Address - Street 1:1870 HARDEMAN AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1161
Practice Address - Country:US
Practice Address - Phone:478-743-2000
Practice Address - Fax:478-743-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028061207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003774426BMedicaid
GA1083742803OtherINDIVIDUAL NPI
GA180038596OtherRR MEDICARE
GA028061OtherMEDICAL LICENSE NUMBER
GAREF000035775Medicaid
GAREF000035775Medicaid
GAE62796Medicare UPIN
GA003774426BMedicaid
GAREF000035775Medicaid