| Georgia Eye Institute Of The Southeast, Llc | |
|
4720 Waters Ave, Savannah, GA 31404-6292 | |
| (912) 354-4800 | |
| (912) 629-5821 |
| Full Name | Georgia Eye Institute Of The Southeast, Llc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 4720 Waters Ave, Savannah, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700039740 | NPI | - | NPPES |
| GP5020 | Other | SC | MEDICAID MD- BLUFFTON |
| DA9642 | Other | SC | MEDICAID OD - BLUFFTON |
| DAG976 | Other | SC | MEDICAID OD |
| GPA977 | Other | SC | MEDICAID MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | William J Degenhart |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699714139 PECOS PAC ID: 6103899406 Enrollment ID: I20040816000550 |
| Provider Name | James G Beisel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336113117 PECOS PAC ID: 8224080338 Enrollment ID: I20050303000948 |
| Provider Name | James Parker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356380927 PECOS PAC ID: 4880651108 Enrollment ID: I20050622000555 |
| Provider Name | Nicholas R Bollin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003831371 PECOS PAC ID: 6002812328 Enrollment ID: I20070928000352 |
| Provider Name | Elizabeth Miller |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1447299011 PECOS PAC ID: 5597854554 Enrollment ID: I20071129000153 |
| Provider Name | Joseph R Gussler |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1437198983 PECOS PAC ID: 5991866519 Enrollment ID: I20081201000699 |
| Provider Name | Sanford I Rosenthal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1891734463 PECOS PAC ID: 3678635356 Enrollment ID: I20081215000746 |
| Provider Name | David D Kim |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508805052 PECOS PAC ID: 7719048339 Enrollment ID: I20081215000761 |
| Provider Name | Christopher Hinson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376582916 PECOS PAC ID: 8426119041 Enrollment ID: I20081215000777 |
| Provider Name | Robert T King |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952340408 PECOS PAC ID: 2365542818 Enrollment ID: I20081215000785 |
| Provider Name | Matthew S Deich |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1740236249 PECOS PAC ID: 9739289869 Enrollment ID: I20081215000789 |
| Provider Name | Robin Ray |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1306006226 PECOS PAC ID: 9234280116 Enrollment ID: I20090707000011 |
| Provider Name | Markesh K Manocha |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1396744181 PECOS PAC ID: 5395885859 Enrollment ID: I20091215000333 |
| Provider Name | Judith Piros |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992720288 PECOS PAC ID: 5799763611 Enrollment ID: I20100625000626 |
| Provider Name | Joseph Reeves |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649299389 PECOS PAC ID: 3971581893 Enrollment ID: I20100714000394 |
| Provider Name | Lyn Oxley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073688115 PECOS PAC ID: 1850405754 Enrollment ID: I20101118000186 |
| Provider Name | Jennifer Goodrich Bromley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1740487131 PECOS PAC ID: 9436337342 Enrollment ID: I20110623000725 |
| Provider Name | Samuel Joseph Overstreet |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063457547 PECOS PAC ID: 8527061373 Enrollment ID: I20140127000274 |
| Provider Name | Shawna S Strub |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205240033 PECOS PAC ID: 7416176938 Enrollment ID: I20140916001273 |
| Provider Name | Rinku Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073948212 PECOS PAC ID: 2769769215 Enrollment ID: I20170510001283 |
| Provider Name | Shari A Carney |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083617419 PECOS PAC ID: 0143577163 Enrollment ID: I20180723002080 |
| Provider Name | Ryan W Piche |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437642543 PECOS PAC ID: 7810249273 Enrollment ID: I20181012000215 |
| Provider Name | Thomas J Kandl |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1366734147 PECOS PAC ID: 9032424502 Enrollment ID: I20181015001366 |
| Provider Name | Heidi E Wise |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982696563 PECOS PAC ID: 9436136900 Enrollment ID: I20191120002318 |
| Provider Name | Nicolle Oberlin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972085165 PECOS PAC ID: 7214332402 Enrollment ID: I20210826001099 |
| Provider Name | Christopher Jay Richmond |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083052955 PECOS PAC ID: 3072970037 Enrollment ID: I20230606002857 |
| Provider Name | Andrea Elizabeth Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760589683 PECOS PAC ID: 6305947615 Enrollment ID: I20231026002544 |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Eye Institute Of The Southeast, Llc 4720 Waters Ave, Savannah, GA 31404-6292 Ph: (912) 354-4800 | Georgia Eye Institute Of The Southeast, Llc 4720 Waters Ave, Savannah, GA 31404-6292 Ph: (912) 354-4800 |