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General NPI Number Information
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NPI Number | 1306657093
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Entity Type | Organization
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Legal Business Name | ANNISTON EYE CENTER, LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 600 LEIGHTON AVE
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City | ANNISTON
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State | AL
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Zip | 36207-5744
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Country | US
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Telephone | 256-238-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 245 HAVEN CIR
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City | RIVERSIDE
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State | AL
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Zip | 35135-1621
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Country | US
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Telephone | 901-827-5925
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. SHONDA WOOD
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Credential | OD
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Telephone | 901-827-5925
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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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