Healthcare Provider Details

I. General information

NPI: 1447394002
Provider Name (Legal Business Name): MARX OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 CHEROKEE AVE SW STE D
CULLMAN AL
35055-7503
US

IV. Provider business mailing address

1850 CHEROKEE AVE SW STE D
CULLMAN AL
35055-7503
US

V. Phone/Fax

Practice location:
  • Phone: 256-775-0499
  • Fax: 256-775-0434
Mailing address:
  • Phone: 256-775-0499
  • Fax: 256-775-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number644
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARCIE ALEXANDER
Title or Position: INSURANCE CLERK
Credential:
Phone: 256-350-6655