Healthcare Provider Details

I. General information

NPI: 1982652293
Provider Name (Legal Business Name): DACHELET & ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CHRISTINE AVE
ANNISTON AL
36207-4657
US

IV. Provider business mailing address

PO BOX 697
ANNISTON AL
36202-0697
US

V. Phone/Fax

Practice location:
  • Phone: 256-236-0300
  • Fax: 256-236-0324
Mailing address:
  • Phone: 256-236-0300
  • Fax: 256-236-0324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateAL

VIII. Authorized Official

Name: DR. RONALD EDWARD DACHELET
Title or Position: OWNER
Credential: O.D.
Phone: 256-236-0300