Healthcare Provider Details

I. General information

NPI: 1346262284
Provider Name (Legal Business Name): JAMIE C. REID O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE CASON O.D.

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5358 HIGHWAY 17
HELENA AL
35080-3604
US

IV. Provider business mailing address

5358 HIGHWAY 17
HELENA AL
35080-3604
US

V. Phone/Fax

Practice location:
  • Phone: 205-664-7577
  • Fax: 205-934-6755
Mailing address:
  • Phone: 205-664-7577
  • Fax: 205-664-7654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberT185TA690
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: