Healthcare Provider Details

I. General information

NPI: 1598659062
Provider Name (Legal Business Name): DR. BRENTON MAXWELL WEEKS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 08/16/2025
Certification Date: 08/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 US HIGHWAY 43
WINFIELD AL
35594-4710
US

IV. Provider business mailing address

PO BOX 1290
WINFIELD AL
35594-1290
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-2860
  • Fax:
Mailing address:
  • Phone: 205-487-2860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-F59-TA-D68
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: