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General NPI Number Information
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NPI Number | 1710481387
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Entity Type | Organization
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Legal Business Name | SOUTHERN EYE CARE ASSOCIATES LLC
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 518 AVENUE A
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City | OPELIKA
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State | AL
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Zip | 36801-5064
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Country | US
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Telephone | 334-745-3112
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Fax | 334-745-8751
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Provider Business Mailing Address
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Address Line | 518 AVENUE A
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City | OPELIKA
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State | AL
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Zip | 36801-5064
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Country | US
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Telephone | 334-745-3112
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Fax | 334-745-8751
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIFFANY M RHYNE
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Credential | OD
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Telephone | 334-745-3112
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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 |
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License Number State | AL
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