Southern Eye Consultants, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002458 Issued in GA

Legal business name

SOUTHERN EYE CONSULTANTS, LLC

Practice address

503 Furys Ferry Rd
Martinez, GA 30907-9059

Phone

(706) 860-8899

Fax

(706) 863-7822

NPI assigned

Aug 9, 2013

Last updated

Aug 15, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHERN EYE CONSULTANTS, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert R Morgan, O.D.

Title

Owner

Phone

(706) 860-8899

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Southern Eye Consultants LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1043643398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079059",
            "telephone_number": "706-860-8899",
            "fax_number": "706-863-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079059",
            "telephone_number": "706-860-8899",
            "fax_number": "706-863-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE CONSULTANTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN EYE CONSULTANTS, LLC",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-860-8899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DG2458",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "724809439B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Martinez, GA
• Providers in Martinez, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.