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General NPI Number Information
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NPI Number | 1700946449
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Entity Type | Organization
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Legal Business Name | CHEAHA EYE ASSOCIATES PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 300 EAST ST N
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City | TALLADEGA
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State | AL
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Zip | 35160-2085
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Country | US
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Telephone | 256-362-5800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 203
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City | BIRMINGHAM
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State | AL
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Zip | 35201-0203
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Country | US
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Telephone | 205-913-8747
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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. DAVID PICKRELL
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Credential | O.D.
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Telephone | 205-913-8747
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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 | S714-TA328
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License Number State | AL
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