Provider Demographics
NPI:1891988465
Name:WALTON EYE CARE, INC.
Entity type:Organization
Organization Name:WALTON EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMMARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-267-4561
Mailing Address - Street 1:517 GREAT OAKS DR.
Mailing Address - Street 2:STE 101
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-8211
Mailing Address - Country:US
Mailing Address - Phone:770-267-4561
Mailing Address - Fax:770-267-8061
Practice Address - Street 1:517 GREAT OAKS DR
Practice Address - Street 2:STE 101
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-8211
Practice Address - Country:US
Practice Address - Phone:770-267-4561
Practice Address - Fax:770-267-8061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP8158Medicare PIN
GA4131860001Medicare NSC