Provider Demographics
NPI:1770764979
Name:SOUTHPOINT EYE CARE PC
Entity type:Organization
Organization Name:SOUTHPOINT EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-990-4480
Mailing Address - Street 1:5900 HILLANDALE DR
Mailing Address - Street 2:SUITE 345
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3802
Mailing Address - Country:US
Mailing Address - Phone:678-990-4480
Mailing Address - Fax:678-990-4481
Practice Address - Street 1:5900 HILLANDALE DR
Practice Address - Street 2:SUITE 345
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3802
Practice Address - Country:US
Practice Address - Phone:678-990-4480
Practice Address - Fax:678-990-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000729462HMedicaid
GAE22235Medicare UPIN
GA18BDGGNMedicare PIN