Basic Information
| Provider Information | |||||||||
| NPI: | 1023299575 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GORLIN EYE ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 875 LAWRENCEVILLE SUWANEE RD | ||||||||
| Address2: | #560 | ||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300438479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709630370 | ||||||||
| FaxNumber: | 7706823719 | ||||||||
| Practice Location | |||||||||
| Address1: | 875 LAWRENCEVILLE SUWANEE RD | ||||||||
| Address2: | #560 | ||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300438479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709630370 | ||||||||
| FaxNumber: | 7706823719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2007 | ||||||||
| LastUpdateDate: | 11/26/2007 | ||||||||
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| AuthorizedOfficialLastName: | GORLIN | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7709630370 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1130 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.