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General NPI Number Information
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NPI Number | 1124140173
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Entity Type | Organization
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Legal Business Name | OPTOMETRY EXCHANGE OF ALABAMA, INC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 11/17/2007
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Provider Practice Location Address
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Address Line | 1088 INDUSTRIAL PKWY
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City | SARALAND
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State | AL
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Zip | 36571-3720
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Country | US
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Telephone | 251-675-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 201 SUMMERVILLE CT
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City | MOBILE
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State | AL
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Zip | 36607-3347
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Country | US
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Telephone | 251-675-3666
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN DAVID DUNSON
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Credential | O.D.
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Telephone | 251-675-3666
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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 | S428TA270
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License Number State | AL
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