MEDICARE: DR. JIM HOUSTON DAY JR. 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
1	152W00000X	Optometrist	S506TA300	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000047107	OTHER	AL	PTAN

General Provider Information

NPI Number	:	1598854275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIM HOUSTON DAY JR. O.D.

Provider Business Mailing Address
First Line	:	2000 RIVERCHASE GALLERIA STE 299B
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-2318
Country	:	US
Telephone Number	:	205-987-2308
Fax Number	:	205-987-2658

Provider Business Practice Location Address
First Line	:	2122 OLD MONTGOMERY HWY
Second Line	:
City	:	PELHAM
State	:	AL
Zip	:	35124-1138
Country	:	US
Telephone Number	:	205-987-2308
Fax Number	:	205-987-2658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	09/04/2024

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