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NPI Code Detail

MEDICARE: DR. JEFFERY BRIAN FORD SR. O.D.

MEDICARE: DR. JEFFERY BRIAN FORD SR. O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WC0802XCorneal and Contact Management OptometristS-910AL
2152WP0200XPediatric OptometristS-910AL
3152W00000XOptometristS-910AL

General Provider Information

NPI Number : 1598843476
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFERY BRIAN FORD SR. O.D.
Provider Business Mailing Address
First Line : 1845 CHERRY ST
Second Line :
City : MONTGOMERY
State : AL
Zip : 36107-2613
Country : US
Telephone Number : 334-420-5001
Fax Number : 334-420-0160
Provider Business Practice Location Address
First Line : 1845 CHERRY ST
Second Line :
City : MONTGOMERY
State : AL
Zip : 36107-2613
Country : US
Telephone Number : 334-420-5001
Fax Number : 334-420-0160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 09/18/2024

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