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General NPI Number Information
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NPI Number | 1043163710
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Entity Type | Organization
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Legal Business Name | HAZEL GREEN EYES
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 14421 AL-431/231 S
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City | HAZEL GREEN
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State | AL
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Zip | 35750
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Country | US
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Telephone | 931-307-4115
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Fax |
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Provider Business Mailing Address
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Address Line | 108 MIMOSA RD
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-7130
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Country | US
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Telephone | 931-307-4115
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. ANDREW DAY BRADFORD II
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Credential | OD
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Telephone | 931-307-4115
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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 |
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License Number State |
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