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General NPI Number Information
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NPI Number | 1093999831
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Entity Type | Organization
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Legal Business Name | FLORENCE EYE CENTER, INC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/09/2013
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Provider Practice Location Address
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Address Line | 506 N MAIN ST
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City | TUSCUMBIA
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State | AL
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Zip | 35674-2049
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Country | US
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Telephone | 256-383-2121
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Fax | 256-383-2131
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Provider Business Mailing Address
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Address Line | 506 N MAIN ST
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City | TUSCUMBIA
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State | AL
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Zip | 35674-2049
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Country | US
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Telephone | 256-383-2121
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Fax | 256-383-2131
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY RAYFORD BASDEN
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Credential | O,D,
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Telephone | 256-383-2121
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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-722-TA-009
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License Number State | AL
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