Altman Eye Clinic, P.C.
Organization Active NPI Optometrist · MC Rae, GA
NPI 1457520587 · NPPES record last updated Apr 9, 2008
Key facts
- NPI
- 1457520587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- OPT000873 (GA)
- Legal business name
- ALTMAN EYE CLINIC, P.C.
- Practice address
- 119 W Pine St
MC Rae, GA 31055-1668 - Phone
- (229) 868-6312
- Fax
- (222) 868-5330
- NPI assigned
- Feb 22, 2008
- Organization subpart
- No
Authorized official
- Name
- David A Altman, O.D.
- Title
- Physican
- Phone
- (229) 868-6312
Practitioners 1
-
David A Altman, O. D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930076570 | GA | DME Supplier - Physician - Optometrist | 6002933942 | Practice locations: MC Rae, GA |
| O20120627000093 | GA | Part B Supplier - Clinic/Group Practice | 6002933942 |
Receives reassigned benefits from 1 practitioner Practice locations: McRae, GA |
National Provider Directory
Locations
11 W Pine St
Mc Rae Helena, GA 31055
Phone (229) 868-6312
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | OPT000873 | GA | Yes |
Addresses
Primary practice location
119 W Pine St
MC Rae, GA 31055-1668
Mailing address
119 W Pine St
MC Rae, GA 31055-1668
Phone (229) 868-6312
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T97490 | Other | GA | UPIN |
Other providers in MC Rae, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.