Healthcare Provider Details

I. General information

NPI: 1962570085
Provider Name (Legal Business Name): SUSAN H EILAND MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 10TH AVE S SUITE 404
BIRMINGHAM AL
35205-1250
US

IV. Provider business mailing address

2700 10TH AVE S SUITE 404
BIRMINGHAM AL
35205-1250
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-2340
  • Fax:
Mailing address:
  • Phone: 205-933-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4320
License Number StateAL

VIII. Authorized Official

Name: DR. SUSAN HORTON EILAND
Title or Position: OWNER
Credential: M.D.
Phone: 205-933-2340