Provider Demographics
NPI:1528472354
Name:NORTH ATLANTA EYE CARE, LLC
Entity type:Organization
Organization Name:NORTH ATLANTA EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:THRELKELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-631-6440
Mailing Address - Street 1:980 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:980 JOHNSON FERRY RD
Practice Address - Street 2:SUITE 550
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1626
Practice Address - Country:US
Practice Address - Phone:404-631-6440
Practice Address - Fax:404-631-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty