Provider Demographics
NPI:1881570174
Name:ATLANTA EYE ASSOCIATES GROUP LLC
Entity type:Organization
Organization Name:ATLANTA EYE ASSOCIATES GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHARJA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-409-8977
Mailing Address - Street 1:1841 CHAMBLEE TUCKER RD STE 1-4B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2784
Mailing Address - Country:US
Mailing Address - Phone:770-409-8977
Mailing Address - Fax:
Practice Address - Street 1:1841 CHAMBLEE TUCKER RD STE 1-4B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-2784
Practice Address - Country:US
Practice Address - Phone:770-409-8977
Practice Address - Fax:404-393-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty