Healthcare Provider Details

I. General information

NPI: 1467807636
Provider Name (Legal Business Name): TERRI LYNN CALL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 UNIVERSITY BLVD HPB G080A
BIRMINGHAM AL
35294-0010
US

IV. Provider business mailing address

1930 TREE TOP LN APT D
VESTAVIA AL
35216-2820
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-2020
  • Fax:
Mailing address:
  • Phone: 256-783-9216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberSD43TAA22
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: