FAYETTE MEDICAL CLINIC OPTICAL SHOP
NPI 1891910618
Ophthalmology in Fayetteville, GA

Q: What is Fayette Medical Clinic Optical Shop's NPI number?

The NPI number for Fayette Medical Clinic Optical Shop is 1891910618. It was assigned to this organization in the NPPES registry on April 16, 2007.

Q: What is Fayette Medical Clinic Optical Shop's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since April 16, 2007

101 YORKTOWN DR STE 225, FAYETTEVILLE, GA 30214(770) 460-2331(770) 460-4016 Get Directions Write a Review

NPPES record last updated: June 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 3, 2021, Aug 22, 2020 (2 updates tracked since 2020).

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About Fayette Medical Clinic Optical Shop NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAYETTE MEDICAL CLINIC OPTICAL SHOP (NPI 1891910618) is a healthcare organization registered as an ophthalmology in Fayetteville, Georgia and active in the NPI registry since April 2007. The organization lists Rick Rodecker, Administrator, as its authorized official.

NPPES Registry Identity

NPI1891910618

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameFAYETTE MEDICAL CLINIC OPTICAL SHOP

Location Address101 YORKTOWN DR STE 225Fayetteville, GA 30214-1568

Mailing Address101 Yorktown Dr Ste 225Fayetteville, GA 30214-1568 · (770) 460-2331 · Fax (770) 460-4016

Phone(770) 460-2331

Fax(770) 460-4016

Organization SubpartNo

Authorized OfficialRick RodeckerAdministrator · (404) 351-2220

Enumeration DateApril 16, 2007

Last NPPES UpdateJune 3, 20212 updates tracked since enumeration

NPPES CertifiedJune 3, 2021

✔ NPI 1891910618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in GA · 20001558

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

101 YORKTOWN DR STE 225, Fayetteville, GA 30214

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fayette Medical Clinic Optical Shop's NPI number?

The NPI number for Fayette Medical Clinic Optical Shop is 1891910618. It was assigned to this organization in the NPPES registry on April 16, 2007.

Where is Fayette Medical Clinic Optical Shop located?

Fayette Medical Clinic Optical Shop is located at 101 Yorktown Dr Ste 225, Fayetteville, GA 30214. The listed phone number is (770) 460-2331.

What is Fayette Medical Clinic Optical Shop's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

When was this NPI record last updated?

The NPPES record for Fayette Medical Clinic Optical Shop was last updated on June 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.