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General NPI Number Information
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NPI Number | 1750688941
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Entity Type | Organization
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Legal Business Name | THE EYE DOCTOR,LLC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 923 STAGE RD STE A
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City | AUBURN
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State | AL
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Zip | 36830-5109
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Country | US
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Telephone | 334-821-3700
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Fax | 334-821-3776
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Provider Business Mailing Address
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Address Line | 923 STAGE RD STE A
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City | AUBURN
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State | AL
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Zip | 36830-5112
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Country | US
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Telephone | 334-740-9048
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Fax | 334-821-3776
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | RANDY STEVEN FIELDS
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Credential | O.D.
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Telephone | 334-740-9048
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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 | S 556
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License Number State | AL
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