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General NPI Number Information
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NPI Number | 1366897597
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Entity Type | Organization
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Legal Business Name | LUKE EYE CARE, LLC
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Dates
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Enumeration Date | 04/25/2016
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 310 18TH ST N SUITE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35203-3122
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Country | US
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Telephone | 205-774-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 3879 JAMES HILL CIR
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City | HOOVER
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State | AL
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Zip | 35226-4707
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Country | US
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Telephone | 229-444-1787
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIFFANY LUKE
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Credential | OD
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Telephone | 229-444-1787
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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 | S-D38-TA-A24
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License Number State | AL
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