Provider Demographics
NPI:1700166394
Name:THE EYES HAVE IT, LLC
Entity Type:Organization
Organization Name:THE EYES HAVE IT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LACHIONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CULPEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:678-572-5705
Mailing Address - Street 1:5174 HICKORY CIR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-3689
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:678-369-8676
Practice Address - Street 1:6525 TARA BLVD
Practice Address - Street 2:SUITE 134
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1227
Practice Address - Country:US
Practice Address - Phone:678-369-8676
Practice Address - Fax:678-369-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003107177AMedicaid