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General NPI Number Information
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NPI Number | 1003521550
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Entity Type | Individual
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Provider Name | ANNA MCCORMICK O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 714 ROSS ST
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City | HEFLIN
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State | AL
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Zip | 36264-1372
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Country | US
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Telephone | 844-480-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 231 BRIARCLIFF RD
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City | HEFLIN
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State | AL
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Zip | 36264-1655
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Country | US
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Telephone | 256-591-0533
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-F16-TA-C89
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License Number State | AL
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