Nicholas Corneillie, OD | |
4465 Jimmy Lee Smith Pkwy Ste 101a, Hiram, GA 30141-2723 | |
(678) 932-5779 | |
Not Available |
Full Name | Nicholas Corneillie |
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Gender | Male |
Speciality | Optometrist |
Location | 4465 Jimmy Lee Smith Pkwy Ste 101a, Hiram, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568196194 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT003435 (Georgia) | Primary |
Provider Name | Southeast Eye Associates |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1598541534 PECOS PAC ID: 9638521099 Enrollment ID: O20240122001770 |
Mailing Address | Practice Location Address |
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Nicholas Corneillie, OD 246 King Arthur Dr, Woodstock, GA 30189-3655 Ph: () - | Nicholas Corneillie, OD 4465 Jimmy Lee Smith Pkwy Ste 101a, Hiram, GA 30141-2723 Ph: (678) 932-5779 |
Hiram Vision Center, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4795 Jimmy Lee Smith Pkwy, Bldg 100 Suite 100, Hiram, GA 30141 Phone: 770-222-6362 | |
Dr. Ingrid A Ellison, M.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4795 Jimmy Lee Smith Pkwy, Suite 101, Hiram, GA 30141 Phone: 770-222-6362 Fax: 866-528-7115 | |
Lynn Family Eyecare Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4166 Jimmy Lee Smith Pkwy, Suite G, Hiram, GA 30141 Phone: 770-439-4230 | |
Laura Jean Shipman, Optometrist Medicare: Medicare Enrolled Practice Location: 5220 Jimmy Lee Smith Pkwy, Hiram, GA 30141 Phone: 770-439-1426 Fax: 770-943-2550 | |
Dr. Kristine Lynn, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4166 Jimmy Lee Smith Pkwy Ste G, Hiram, GA 30141 Phone: 770-439-4230 | |
Dr. Patrick Wayne Schrepel, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4465 Jimmy Lee Smith Pkwy Ste 101a, Hiram, GA 30141 Phone: 678-932-5779 | |
Dr. Sylvester Ayewoh, OD Optometrist Medicare: Medicare Enrolled Practice Location: 4373 Jimmy Lee Smith Pkwy Ste 101, Hiram, GA 30141 Phone: 770-943-2220 Fax: 770-943-4245 |