| Marietta Eye Clinic, Pa | |
|
895 Canton Rd Ne, Building 100, Marietta, GA 30060 | |
| (770) 427-8111 | |
| (770) 499-1643 |
| Full Name | Marietta Eye Clinic, Pa |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 895 Canton Rd Ne, Marietta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255333175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Mark S Dickinson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457430464 PECOS PAC ID: 4284622671 Enrollment ID: I20040505000927 |
| Provider Name | Christa K Lows |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588665699 PECOS PAC ID: 5496734105 Enrollment ID: I20040716000178 |
| Provider Name | Lakshmana M Kooragayala |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1497757496 PECOS PAC ID: 1153302476 Enrollment ID: I20050701000101 |
| Provider Name | Denise A Johnson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1720060114 PECOS PAC ID: 5890711584 Enrollment ID: I20051021000453 |
| Provider Name | Andre S Cohen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1679597884 PECOS PAC ID: 1557304839 Enrollment ID: I20060828000008 |
| Provider Name | Brian E Saunders |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912974700 PECOS PAC ID: 7810094398 Enrollment ID: I20070517000264 |
| Provider Name | Shunai Jiang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1265570840 PECOS PAC ID: 0446350797 Enrollment ID: I20070716000349 |
| Provider Name | Rhonda L Thompson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245262278 PECOS PAC ID: 6002904877 Enrollment ID: I20071112000387 |
| Provider Name | Byron A Long |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1225030182 PECOS PAC ID: 5193754877 Enrollment ID: I20080602000472 |
| Provider Name | Paul G Mitchell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1912909813 PECOS PAC ID: 8022047703 Enrollment ID: I20080602000616 |
| Provider Name | Leonard M Thurschwell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881696763 PECOS PAC ID: 2163592163 Enrollment ID: I20080603000352 |
| Provider Name | Charles C Ho |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1780685834 PECOS PAC ID: 2567491244 Enrollment ID: I20080603000360 |
| Provider Name | Cara Patterson Robison |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972750842 PECOS PAC ID: 6103985759 Enrollment ID: I20081111000569 |
| Provider Name | Louis M Schlesinger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477557957 PECOS PAC ID: 2668651969 Enrollment ID: I20110119000294 |
| Provider Name | Brandy Augustine |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457404170 PECOS PAC ID: 7416135991 Enrollment ID: I20110705000368 |
| Provider Name | Stephen M. John |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275763062 PECOS PAC ID: 3971771106 Enrollment ID: I20110714000248 |
| Provider Name | Annal D Meleth |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1962668046 PECOS PAC ID: 8729229885 Enrollment ID: I20130801000301 |
| Provider Name | Justin R Wilkin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184949687 PECOS PAC ID: 9931345485 Enrollment ID: I20140926002044 |
| Provider Name | Allison A Dublin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1770791725 PECOS PAC ID: 4880843762 Enrollment ID: I20150507002054 |
| Provider Name | Amy Marie Cherof |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1164786976 PECOS PAC ID: 8123268968 Enrollment ID: I20160808001112 |
| Provider Name | Puneet Panda |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1073827895 PECOS PAC ID: 7416176839 Enrollment ID: I20160906000538 |
| Provider Name | Monica L Bratton |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1700013653 PECOS PAC ID: 9032350434 Enrollment ID: I20170202001643 |
| Provider Name | Brittany E Mcneely |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811370331 PECOS PAC ID: 5294022331 Enrollment ID: I20180725003079 |
| Provider Name | Zakiya O Nicks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518122159 PECOS PAC ID: 6507931953 Enrollment ID: I20180816002248 |
| Provider Name | Kayla E Akers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356791933 PECOS PAC ID: 1355619388 Enrollment ID: I20180921002550 |
| Provider Name | Drake Robert Devos |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669902094 PECOS PAC ID: 0648523803 Enrollment ID: I20181105003544 |
| Provider Name | Jeffrey Tran |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1285098533 PECOS PAC ID: 3274959457 Enrollment ID: I20200818003910 |
| Provider Name | Courtney G Cape |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396398855 PECOS PAC ID: 8022346709 Enrollment ID: I20201006000166 |
| Provider Name | Bilal K Yousufzai |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023458916 PECOS PAC ID: 0143463802 Enrollment ID: I20201026000346 |
| Provider Name | Hayden Matli |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336722800 PECOS PAC ID: 5092104869 Enrollment ID: I20211116003022 |
| Provider Name | Mahsa Katherine Masoudi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194396309 PECOS PAC ID: 7214322379 Enrollment ID: I20220328001560 |
| Provider Name | Mark F Morel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1720584329 PECOS PAC ID: 7113278771 Enrollment ID: I20220707001735 |
| Provider Name | Edward Washington |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1104211283 PECOS PAC ID: 4789970369 Enrollment ID: I20220802001847 |
| Provider Name | Holly Carringer Gutierrez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588862205 PECOS PAC ID: 0648360891 Enrollment ID: I20221002000007 |
| Provider Name | Emily Laga |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336711944 PECOS PAC ID: 7810373586 Enrollment ID: I20221004000110 |
| Provider Name | Bryan Thiel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1356845556 PECOS PAC ID: 9739580507 Enrollment ID: I20221010001584 |
| Provider Name | Ravali Gummi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033615299 PECOS PAC ID: 5597013334 Enrollment ID: I20221109002114 |
| Provider Name | Crystal Ahn Sol |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770219818 PECOS PAC ID: 6800240607 Enrollment ID: I20230927004080 |
| Provider Name | Karrie I Sestak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902597222 PECOS PAC ID: 3779931365 Enrollment ID: I20231120002678 |
| Provider Name | Meredith Anne Fry |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578258968 PECOS PAC ID: 7618339839 Enrollment ID: I20240717003976 |
| Provider Name | Rebecca Greta Li |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1487275889 PECOS PAC ID: 1759702319 Enrollment ID: I20241014002022 |
| Provider Name | Linsey Bergstrom |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073202727 PECOS PAC ID: 8224499108 Enrollment ID: I20241017000368 |
| Provider Name | Rachel Ressler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205524295 PECOS PAC ID: 1153776588 Enrollment ID: I20241024001843 |
| Mailing Address | Practice Location Address |
|---|---|
| Marietta Eye Clinic, Pa 895 Canton Rd Ne, Building 100, Marietta, GA 30060-8934 Ph: (770) 427-8111 | Marietta Eye Clinic, Pa 895 Canton Rd Ne, Building 100, Marietta, GA 30060 Ph: (770) 427-8111 |