East Ga Regional Eye Center
Specialist in Statesboro, GA. Organization (NPI-2).
NPI number1750488011
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1750488011
- Entity type
- Organization (NPI-2)
- Legal business name
- East Ga Regional Eye Center
- Organization subpart
- No
- Enumeration date
- Sep 20, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 045642 | GA | Yes |
Practice location
21 N Zetterower AveStatesboro, GA 30458-7142
Phone 912-764-6357 · Fax 912-764-2192
Mailing address
21 N Zetterower AveStatesboro, GA 30458-7142
Phone 912-764-6357 · Fax 912-764-2192
Authorized official
Jack Robert Tenzel
President
9127646357
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