MEDICARE: DR. ERNEST JONATHAN CHAMPION OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	S-908 TA 463	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95104	OTHER	AL	BLUE CROSS PIN #

General Provider Information

NPI Number	:	1740261601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST JONATHAN CHAMPION OD

Provider Business Mailing Address
First Line	:	1120 AIRPORT DR
Second Line	:	STE 104
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3436
Country	:	US
Telephone Number	:	256-329-8400
Fax Number	:	256-329-8200

Provider Business Practice Location Address
First Line	:	1120 AIRPORT DR
Second Line	:	STE 104
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3436
Country	:	US
Telephone Number	:	256-329-8400
Fax Number	:	256-329-8200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/29/2007

Similar Medicare Providers

1811979982 — JAMES HOWARD POOLE O.D.
Practice Location Address:

1120 AIRPORT DR , SUITE104
ALEXANDER CITY, AL
35010-3436

Practice Phone: 256-329-8400
Practice Fax: 256-329-8200

1114067741 — JAMES H. POOLE & ASSOCIATES, O.D., P.C.
Practice Location Address:

1120 AIRPORT DR , SUITE 104
ALEXANDER CITY, AL
35010-3436

Practice Phone: 256-329-8400
Practice Fax: 256-329-8200

1699895490 — DADEVILLE SPORTS MEDICINE & PHYSICAL THERAPY
Practice Location Address:

1120 AIRPORT DR , SUITE 103
ALEXANDER CITY, AL
35010-3436

Practice Phone: 256-329-8180
Practice Fax: 256-329-8116

1174051643 — AMANDA HARDY CRNP
Practice Location Address:

1120 AIRPORT DR
ALEXANDER CITY, AL
35010-3436

Practice Phone: 256-212-9300
Practice Fax:

1518007632 — SAIF ULLAH FAROOQ MD
Practice Location Address:

4221 S WESTERN AVE STE 4005
OKLAHOMA CITY, OK
73109-3436

Practice Phone: 405-644-5040
Practice Fax: 405-644-5039

1518181379 — HOLLYWOOD RECOVERY TREATMENT CENTER
Practice Location Address:

12500 RIVERSIDE DR STE 211
STUDIO CITY, CA
91607-3436

Practice Phone: 818-980-0849
Practice Fax: 818-980-0859

Directions to “ DR. ERNEST JONATHAN CHAMPION OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.