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General NPI Number Information
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NPI Number | 1255104808
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Entity Type | Organization
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Legal Business Name | MCCORMICK EYE CARE, LLC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 714 ROSS ST
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City | HEFLIN
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State | AL
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Zip | 36264-1372
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Country | US
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Telephone | 256-591-0533
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Fax | 256-770-4846
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Provider Business Mailing Address
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Address Line | 714 ROSS ST
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City | HEFLIN
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State | AL
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Zip | 36264-1372
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Country | US
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Telephone | 256-591-0533
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Fax | 256-770-4846
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Authorized Official
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Title or Position | OPTOMETRIST/ OWNER
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Name | DR. ANNA ELIZABETH MCCORMICK
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Credential | O.D.
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Telephone | 256-591-0533
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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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