Healthcare Provider Details

I. General information

NPI: 1609842459
Provider Name (Legal Business Name): AMY H. HERRINGTON O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/07/2023
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 ACTON RD STE 161
VESTAVIA AL
35243-2939
US

IV. Provider business mailing address

2409 ACTON RD STE 161
VESTAVIA AL
35243-2939
US

V. Phone/Fax

Practice location:
  • Phone: 205-202-9607
  • Fax: 205-337-0843
Mailing address:
  • Phone: 205-202-9607
  • Fax: 205-337-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-682-TA-193
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: