Southern Eye Clinic P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2006#017184 Issued in GA

Legal business name

SOUTHERN EYE CLINIC P.C.

Doing business as

Southern Eye Center

Practice address

1306 Troupe St
Augusta, GA 30904-4755

Phone

(706) 736-1437

Fax

(706) 733-6414

NPI assigned

Mar 10, 2006

Last updated

Aug 22, 2020By 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

Dr. William V Tillery, M.D.

Title

President

Phone

(706) 736-1437

Specialties & licenses 1

Addresses

Other names 1

• Southern Eye Center Doing business as

Locations

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285602672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 TROUPE ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044755",
            "telephone_number": "706-736-1437",
            "fax_number": "706-733-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 TROUPE ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044755",
            "telephone_number": "706-736-1437",
            "fax_number": "706-733-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-736-1437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "2006#017184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Southern Anesthesia of Augusta LLC
• Southern Family Medical Center PC
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc. (ResCare HomeCare)
• Southern Home Care Services, Inc. (ResCare HomeCare)
• Southern Home Care Services, Inc.

• Ophthalmology Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Ophthalmology Physician 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.