Provider Demographics
NPI:1124662945
Name:CHILDREN'S EYE CARE AND SURGERY OF GEORGIA PC
Entity type:Organization
Organization Name:CHILDREN'S EYE CARE AND SURGERY OF GEORGIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:LIPSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-858-5437
Mailing Address - Street 1:5185 PEACHTREE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-6545
Mailing Address - Country:US
Mailing Address - Phone:770-858-5437
Mailing Address - Fax:
Practice Address - Street 1:5185 PEACHTREE PKWY STE 350
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-6545
Practice Address - Country:US
Practice Address - Phone:678-517-6846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Single Specialty