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General NPI Number Information
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NPI Number | 1194087064
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Entity Type | Organization
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Legal Business Name | EAMC EYE CLINIC, LLC
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 122 N 20TH ST BLDG 26
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City | OPELIKA
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State | AL
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Zip | 36801-5442
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Country | US
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Telephone | 334-749-1486
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Fax |
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Provider Business Mailing Address
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Address Line | 122 N 20TH ST BLDG 26
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City | OPELIKA
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State | AL
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Zip | 36801-5442
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Country | US
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Telephone | 334-749-1486
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. SAMUEL PRICE JR.
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Credential |
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Telephone | 334-528-1310
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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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