Provider Demographics
NPI:1750388203
Name:EYE ASSOCIATES OF TALLAHASSEE, P.A.
Entity type:Organization
Organization Name:EYE ASSOCIATES OF TALLAHASSEE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:850-878-6161
Mailing Address - Street 1:2020 FLEISCHMANN RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4599
Mailing Address - Country:US
Mailing Address - Phone:850-878-6161
Mailing Address - Fax:850-656-0200
Practice Address - Street 1:2020 FLEISCHMANN RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4599
Practice Address - Country:US
Practice Address - Phone:850-878-6161
Practice Address - Fax:850-656-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL39777207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0637408-00Medicaid
GA180259984OtherTRAVELER'S RAILROAD MED.
SC0539810001OtherPALMETTO GBA MEDICARE P&B
SC0539810001OtherPALMETTO GBA MEDICARE P&B