South Georgia Eye Partners PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTH GEORGIA EYE PARTNERS PC

Practice address

416 Tift Ave N
Tifton, GA 31794-4466

Phone

(229) 391-4180

Fax

(229) 391-2929

NPI assigned

Jun 16, 2010

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, MD

Title

Owner

Phone

(229) 244-2068

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1477874253",
    "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 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2013-02-13",
        "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": "229-244-2068",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY 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 Georgia CSB
• South Georgia CSB
• South Georgia Dermatology, PC
• South Georgia Drug Company LLC
• South Georgia Eye Partners
• South Georgia Medicine, P.C.
• South Georgia Neurological Associates, P.C.
• South Georgia Pain Management
• South Georgia Physicians for Women
• South Georgia Surgical Clinic PC

• 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 Feb 13, 2013; 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.