1992947717 NPI number — FOR YOUR EYES ONLY-EYE CARE INC

Table of content: DR. ROBERT GENE MEALER M.D., PH.D. (NPI 1003157504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992947717 NPI number — FOR YOUR EYES ONLY-EYE CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOR YOUR EYES ONLY-EYE CARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992947717
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5851 S VICKERY ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUMMING
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30040-8793
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-682-9299
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5851 S VICKERY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMMING
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30040-8793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-682-9299
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SIVAN
Authorized Official First Name:
MIRA
Authorized Official Middle Name:
KALMAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
678-682-9299

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  2413 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com