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General NPI Number Information
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NPI Number | 1700172954
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Entity Type | Individual
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Provider Name | MERIN AMANDA GRAVES O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 1755 AL-77
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City | SOUTHSIDE
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State | AL
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Zip | 35907-0103
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Country | US
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Telephone | 256-442-6200
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Fax | 256-442-6292
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Provider Business Mailing Address
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Address Line | 1431 2ND AVE N
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City | BESSEMER
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State | AL
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Zip | 35020-5608
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Country | US
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Telephone | 205-425-5182
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Fax | 205-426-5013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPC 4669
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-C72-TA-911
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7827T
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License Number State | TX
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