Provost Eye Group, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002244 Issued in GA

Legal business name

PROVOST EYE GROUP, P.C.

Practice address

2900 Cumberland Mall SE
Atlanta, GA 30339

Phone

(770) 431-1713

Fax

(770) 431-1714

NPI assigned

Aug 19, 2006

Last updated

Jul 26, 2007By 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. Drew Alex Provost, O.D.

Title

President

Phone

(770) 431-1713

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1861507261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CUMBERLAND MALL SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "770-431-1713",
            "fax_number": "770-431-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CUMBERLAND MALL SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "770-431-1713",
            "fax_number": "770-431-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVOST EYE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "PROVOST",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-431-1713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Healthcare Services, Inc (Boston Healthcare Alliance)
• Providence Home Care LLC
• Providence Medical Group, PC
• Providence Transportation LLC
• Cathleen Ann Provins, RN, ACNP-BC, PHD
• Michael Provost, DC
• Kristina Prox, RDN, LD
• Lindsey Prozzillo, CPNP
• Prudent Senior Services of Georgia
• Astrid Prudent

• Optometrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.