| Lake Lanier Eye Care, Llc | |
|
5885 Cumming Hwy Ste 401-402, Sugar Hill, GA 30518-5765 | |
| (678) 926-3525 | |
| Not Available |
| Full Name | Lake Lanier Eye Care, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 5885 Cumming Hwy Ste 401-402, Sugar Hill, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013312453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPT002752 (Georgia) | Primary |
| Provider Name | Brett S Bordner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578904314 PECOS PAC ID: 8022250182 Enrollment ID: I20130820000551 |
| Provider Name | Derek Black |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114353232 PECOS PAC ID: 9133410848 Enrollment ID: I20160627001622 |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Lanier Eye Care, Llc 205 Highland Gate Cir, Suwanee, GA 30024-1795 Ph: (662) 910-0735 | Lake Lanier Eye Care, Llc 5885 Cumming Hwy Ste 401-402, Sugar Hill, GA 30518-5765 Ph: (678) 926-3525 |
Agnes Adu, OD Optometrist Medicare: Medicare Enrolled Practice Location: 373 Westwater Rdg, Sugar Hill, GA 30518 Phone: 770-598-7512 | |
Tiffany Monet Jones, OD Optometrist Medicare: Medicare Enrolled Practice Location: 5115 Gable Ridge Way, Sugar Hill, GA 30518 Phone: 404-697-8969 | |
Dr. Marga Rita Wastalu, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 215 Beech Tree Holw, Sugar Hill, GA 30518 Phone: 678-765-2999 Fax: 678-765-7334 |