=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588606685
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANE LUCINDA WRIGHT O.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2006
-----------------------------------------------------
Last Update Date | 04/08/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5161C MOORES MILL RD
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35811-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-852-6560
-----------------------------------------------------
Fax | 256-852-6501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5161 MOORES MILL RD.
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35811-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-852-6560
-----------------------------------------------------
Fax | 256-852-6501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | S-972-TA-544
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------