Georgia Eye Institute Of The Southeast, LLC
Ophthalmology in Pooler, GA. Organization (NPI-2).
NPI number1124519954
StatusActive
Last updated in NPPESJul 16, 2025
Details
- NPI
- 1124519954
- Entity type
- Organization (NPI-2)
- Legal business name
- Georgia Eye Institute Of The Southeast, LLC
- Organization subpart
- Yes
- Enumeration date
- May 29, 2018
- Certification date
- Jul 16, 2025
- Last updated
- Jul 16, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
| 207WX0009X | Ophthalmology, Glaucoma Specialist | – | – | |
| 207WX0120X | Ophthalmology, Cornea and External Diseases Specialist | – | – | |
| 207WX0200X | Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery | – | – |
Practice location
1000 Towne Center Blvd Ste 806Pooler, GA 31322-4070
Phone 912-450-3500 · Fax 912-629-5821
Mailing address
4720 Waters AveSavannah, GA 31404-6292
Phone 912-354-4800 · Fax 912-629-5821
Authorized official
Erica Leigh Moreland
Director, Revenue Cycle
9123544800
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