Southern Eye Excellence, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

047403 Issued in GA

Legal business name

SOUTHERN EYE EXCELLENCE, LLC

Practice address

5900 Hillandale Drive
Suite 345
Lithonia, GA 30058-6803

Phone

(770) 987-0733

Fax

(770) 987-3978

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence F Brack III, M.D.NPI 1265441315

Title

Physician

Phone

(770) 987-0733

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence F Brack III, M.D.

  • Ophthalmology Physician
  • Lithonia, GA
  • NPI 1265441315
  NPD (past) Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598860801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 HILLANDALE DRIVE",
            "address_2": "SUITE 345",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586803",
            "telephone_number": "770-987-0733",
            "fax_number": "770-987-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 HILLANDALE DRIVE",
            "address_2": "SUITE 345",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586803",
            "telephone_number": "770-987-0733",
            "fax_number": "770-987-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE EXCELLENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRACK",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-987-0733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "047403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brooks Spears III, RBT
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• L. Lynn Spencer
• Brenda Spiers

• Ophthalmology Physician in Lithonia, GA
• Providers in Lithonia, 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.