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General NPI Number Information
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NPI Number | 1134717572
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Entity Type | Organization
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Legal Business Name | DRY EYE CENTER OF ALABAMA, LLC
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Dates
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Enumeration Date | 12/31/2020
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Last Update Date | 12/31/2020
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Provider Practice Location Address
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Address Line | 3490 INDEPENDENCE DR STE 110
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City | BIRMINGHAM
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State | AL
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Zip | 35209-5604
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Country | US
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Telephone | 205-490-2322
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Fax | 205-510-9469
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Provider Business Mailing Address
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Address Line | 3490 INDEPENDENCE DR STE 110
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City | BIRMINGHAM
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State | AL
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Zip | 35209-5604
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Country | US
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Telephone | 205-490-2322
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Fax | 205-510-9469
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Authorized Official
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Title or Position | PRACTICING OWNER
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Name | DR. CHARLES DERRICK FRANKLIN
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Credential | OD
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Telephone | 205-490-2322
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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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