Healthcare Provider Details

I. General information

NPI: 1154312338
Provider Name (Legal Business Name): KYE L MANSFIELD OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3429 PELHAM PKWY
PELHAM AL
35124-2009
US

IV. Provider business mailing address

3429 PELHAM PKWY
PELHAM AL
35124-2009
US

V. Phone/Fax

Practice location:
  • Phone: 205-663-3937
  • Fax:
Mailing address:
  • Phone: 205-663-3937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS869TA410
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: