MEDICARE: ALABAMA VISION CENTER, LLC

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
2	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	N044	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1992807259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA VISION CENTER, LLC

Provider Business Mailing Address
First Line	:	790 MONTCLAIR RD
Second Line	:	SUITE 100
City	:	BIRMINGHAM
State	:	AL
Zip	:	35213-1966
Country	:	US
Telephone Number	:	205-592-3911
Fax Number	:	205-592-3537

Provider Business Practice Location Address
First Line	:	790 MONTCLAIR RD
Second Line	:	SUITE 100
City	:	BIRMINGHAM
State	:	AL
Zip	:	35213-1966
Country	:	US
Telephone Number	:	205-592-3911
Fax Number	:	205-592-3537

Authorized Official
Title or Position	:	CMO/AUTHORIZED OFFICIAL
Name	:	MR. JOSEPH GIRA
Credential	:	MD
Telephone Number	:	636-227-2600

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	10/25/2024

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Directions to “ALABAMA VISION CENTER, LLC ” Practice Location

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