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General NPI Number Information
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NPI Number | 1881618403
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Entity Type | Organization
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Legal Business Name | BAY EYES SURGERY CENTER
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 411 NORTH SECTION STREET
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City | FAIRHOPE
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State | AL
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Zip | 36532
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Country | US
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Telephone | 251-990-3937
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Fax | 251-990-9990
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Provider Business Mailing Address
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Address Line | PO BOX 2020
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City | FAIRHOPE
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State | AL
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Zip | 36533-2020
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Country | US
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Telephone | 251-990-3937
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Fax | 251-990-9990
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Authorized Official
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Title or Position | OWNER/ DOCTOR
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Name | DR. JOSEPH F GRAVLEE JR.
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Credential | M.D.
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Telephone | 251-990-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 12947
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License Number State | AL
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