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General NPI Number Information
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NPI Number | 1780966119
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Entity Type | Organization
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Legal Business Name | EYECARE SPECIALISTS OF ALABAMA LLC
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 4144 ASHINGTON DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-5836
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Country | US
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Telephone | 205-908-5143
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Fax |
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Provider Business Mailing Address
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Address Line | 4144 ASHINGTON DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-5836
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Country | US
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Telephone | 205-908-5143
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEAH P KIRKEMIER
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Credential | OD
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Telephone | 205-908-5143
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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 | SB37TA729
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License Number State | AL
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