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General NPI Number Information
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NPI Number | 1306877261
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Entity Type | Organization
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Legal Business Name | NORTHEAST ALABAMA EYE SURGERY CENTER
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 314 S 5TH ST
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City | GADSDEN
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State | AL
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Zip | 35901-4224
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Country | US
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Telephone | 256-547-8634
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Fax | 404-410-1211
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Provider Business Mailing Address
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Address Line | 500 ROSS ST 154-0455 BOX 360414
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City | PITTSBURGH
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State | PA
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Zip | 15262-0001
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Country | US
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Telephone | 256-547-8634
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Fax | 256-547-3039
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Authorized Official
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Title or Position | CHIEF REVENUE CYCLE OFFICER
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Name | CANDICE B DAVIS
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Credential |
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Telephone | 916-990-7590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 5650
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License Number State | AL
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