Eye Center Optical, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE CENTER OPTICAL, LLC

Practice address

2108 N Patterson St
Valdosta, GA 31602-2947

Phone

(229) 244-2790

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kristian Keesling, C.P.A.

Title

Cfo

Phone

(229) 244-3000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063624997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3223",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316043223",
            "telephone_number": "229-244-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022947",
            "telephone_number": "229-244-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEESLING",
        "authorized_official_first_name": "KRISTIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-244-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.A."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Valdosta, GA
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• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.