Healthcare Provider Details

I. General information

NPI: 1407856438
Provider Name (Legal Business Name): SHILPA J PATEL OD, MS, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHILPA J REGISTER OD

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 08/05/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 EMINENCE WAY STE A
PELL CITY AL
35128-2338
US

IV. Provider business mailing address

41 EMINENCE WAY STE A
PELL CITY AL
35128-2338
US

V. Phone/Fax

Practice location:
  • Phone: 205-206-4518
  • Fax: 205-891-8131
Mailing address:
  • Phone: 205-206-4518
  • Fax: 205-884-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS967TA525
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4423
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-967-TA-525
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: