=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881855229
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | D & K EYEWEAR
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2008
-----------------------------------------------------
Last Update Date | 11/29/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2567 BELL ROAD
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36117-4369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-386-2751
-----------------------------------------------------
Fax | 334-386-2754
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2567 BELL ROAD
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36117-4369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-386-2751
-----------------------------------------------------
Fax | 334-386-2754
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. APRIL NICOLE HILL
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 334-386-2751
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | S-C59-TA-897
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 156FX1800X
-----------------------------------------------------
Taxonomy Name | Optician
-----------------------------------------------------
License Number | S-C59-TA-897
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 156FX1800X
-----------------------------------------------------
Taxonomy Name | Optician
-----------------------------------------------------
License Number | 446199
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------