MEDICARE: IN FOCUS INC,

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	S835-TA-385	TN

General Provider Information

NPI Number	:	1942634621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN FOCUS INC,

Provider Business Mailing Address
First Line	:	6125 UNIVERSITY DR NW
Second Line	:	SUITE D-10
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-1757
Country	:	US
Telephone Number	:	256-971-9700
Fax Number	:	256-971-9710

Provider Business Practice Location Address
First Line	:	6125 UNIVERSITY DR NW
Second Line	:	SUITE D-10
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-1757
Country	:	US
Telephone Number	:	256-971-9700
Fax Number	:	256-971-9710

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GREGORY W CLARDY
Credential	:	O.D.
Telephone Number	:	256-971-9700

Provider Enumeration Date	:	08/29/2013
Last Update Date	:	08/29/2013

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