Provider Demographics
NPI:1952761694
Name:NELMS EYECARE, P.C.
Entity Type:Organization
Organization Name:NELMS EYECARE, P.C.
Other - Org Name:ADVANCED EYECARE OPTICAL OF OCONEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:NELMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:706-310-5050
Mailing Address - Street 1:1011 STONEBRIDGE PKWY
Mailing Address - Street 2:STE. 106
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-6011
Mailing Address - Country:US
Mailing Address - Phone:706-310-5050
Mailing Address - Fax:706-310-5053
Practice Address - Street 1:1011 STONEBRIDGE PKWY
Practice Address - Street 2:STE. 106
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-6011
Practice Address - Country:US
Practice Address - Phone:706-310-5050
Practice Address - Fax:706-310-5053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT2905261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty