Provider Demographics
NPI:1366519944
Name:CENTER FOR SIGHT PC
Entity type:Organization
Organization Name:CENTER FOR SIGHT PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-922-2201
Mailing Address - Street 1:1400 WELLBROOK CIR NE
Mailing Address - Street 2:STE 100
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3825
Mailing Address - Country:US
Mailing Address - Phone:770-922-2201
Mailing Address - Fax:
Practice Address - Street 1:1400 WELLBROOK CIR NE
Practice Address - Street 2:STE 100
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3825
Practice Address - Country:US
Practice Address - Phone:770-922-2201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023487207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
133427617OtherPENS SS#
GA00248487FMedicaid
GA55002348AMedicaid
GA00248487FMedicaid
GA00248487FMedicaid
GA180001458Medicare ID - Type UnspecifiedRAILROAD MEDICARE
GA0372410001Medicare NSC
GACC2316Medicare ID - Type UnspecifiedRR GROUP NO
GA=========OtherTAX ID NUMBER
GA55002348AMedicaid