Provider Demographics
NPI:1982280616
Name:FAMILY FIRST VISION CARE GEORGIA
Entity type:Organization
Organization Name:FAMILY FIRST VISION CARE GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-545-4465
Mailing Address - Street 1:4680 PARKWAY DR STE 22
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8296
Mailing Address - Country:US
Mailing Address - Phone:513-445-9064
Mailing Address - Fax:
Practice Address - Street 1:890 DAWSONVILLE HWY STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2608
Practice Address - Country:US
Practice Address - Phone:770-532-4171
Practice Address - Fax:770-532-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty