South Georgia Eye Partners

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTH GEORGIA EYE PARTNERS

Practice address

416 Tift Ave N
Tifton, GA 31794-4466

Phone

(229) 391-4180

Fax

(229) 391-2929

NPI assigned

Jun 15, 2012

Last updated

Jun 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott H Petermann, MDNPI 1043215759

Title

Owner

Phone

(229) 391-4126

Specialties & licenses 6

Addresses

Tax ID family

South Ga Eye Partners PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Georgia Eye Partners, PC

  • Optometrist
  • Valdosta, GA
  • NPI 1609171800
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott H Petermann, MD

  • Ophthalmology Physician
  • Valdosta, GA
  • NPI 1043215759
  Authorized official Same address or phone

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1093077984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026921",
            "telephone_number": "229-244-2068",
            "fax_number": "229-244-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 TIFT AVE N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944466",
            "telephone_number": "229-391-4180",
            "fax_number": "229-391-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA EYE PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "PETERMANN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-391-4126",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Ga Orthopedic Resources Inc
• South Georgia CSB (Behavioral Health Svcs of S GA)
• South Georgia CSB (Tift C&A Outpatient Services)
• South Georgia Dermatology, PC
• South Georgia Drug Company LLC (Friendly City Pharmacy)
• South Georgia Eye Partners PC
• South Georgia Medicine, P.C.
• South Georgia Neurological Associates, P.C.
• South Georgia Pain Management
• South Georgia Physicians for Women

• Ophthalmology Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.