Reagin Optometric Group, P.A.

LBN: Reagin Optometric Group, P.A.
Reagin Optometric Group, P.A. is an health care organization with primary practice located at 104 Church St , Decatur GA 30030-3325. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Reagin Optometric Group, P.A. can be contacted via phone (404) 378-3694, or through Reagin, Wallis E. via phone (404) 378-3694.

Contact Information

Primary practice address
104 Church St Decatur GA 30030-3325
Phone: (404) 378-3694
Fax: (404) 373-0741
Website:
Map and Directions
Authorized official contact:
Name: Reagin, Wallis E. Doctor of Optometry (OD)
Phone: (404) 378-3694

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 486 Georgia

Profile Details

NPI number 1447391594
LBN Legal business name Reagin Optometric Group, P.A.
DBA Doing business as
Authorized official Reagin, Wallis E. Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 10th, 2007
Last updated Jan 17th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447391594 NPPES
Georgia MEDICAID 00004408A

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