Southern Eye Center, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

025970 Issued in GA

Legal business name

SOUTHERN EYE CENTER, PC

Doing business as

Southern Eye Center, PC

Practice address

2310 N Patterson St
Suite B
Valdosta, GA 31602-2568

Phone

(229) 247-2020

Fax

(229) 247-5600

NPI assigned

Oct 24, 2006

Last updated

Nov 1, 2011By 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. Mark Joseph Eanes Sr., MD

Title

President

Phone

(229) 247-2020

Specialties & licenses 3

Addresses

Other names 1

• SOUTHERN EYE CENTER, PC Doing business as

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

  Specialist

  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1316020043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N PATTERSON ST",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022568",
            "telephone_number": "229-247-2020",
            "fax_number": "229-247-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N PATTERSON ST",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022568",
            "telephone_number": "229-247-2020",
            "fax_number": "229-247-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "EANES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-247-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002069",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "025970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN EYE CENTER, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Health District (South Health District EI)
• South Health District (South Health District C1st)
• South Health District (South Health District PCM)
• South Health District (Lowndes Co BOH AHPC - Valdosta)
• South Health District 8-1 (Infectious Disease Program)
• Southern Healthcare Alliance, LLC (Southern Neurology, Physical Medicine & Rehabilitation)
• Southern Home Care
• Southern Home Care
• Southern Home Care
• Southern Home Care

• Specialist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.