Healthcare Provider Details

I. General information

NPI: 1285768499
Provider Name (Legal Business Name): TOTAL EYE CARD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 POINCIANA DR
BIRMINGHAM AL
35209
US

IV. Provider business mailing address

428 POINCIANA DR
BIRMINGHAM AL
35209
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-8383
  • Fax:
Mailing address:
  • Phone: 205-871-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-613-TA-334
License Number StateAL

VIII. Authorized Official

Name: DR. TODD MCDOWELL
Title or Position: PRESIDENT
Credential: O.D.
Phone: 205-871-8383