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General NPI Number Information
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NPI Number | 1588878714
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Entity Type | Organization
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Legal Business Name | BESSEMER EYE CLINIC P.C.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 1511 4TH AVE N
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City | BESSEMER
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State | AL
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Zip | 35020-5764
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Country | US
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Telephone | 205-425-2401
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 4TH AVE N
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City | BESSEMER
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State | AL
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Zip | 35020-5764
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Country | US
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Telephone | 205-425-2401
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEON A RENAUD
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Credential | O.D.
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Telephone | 205-425-2401
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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 | S329TA075
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License Number State | AL
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