Provider Demographics
NPI:1003029257
Name:EYE SURGERY CENTER OF NORTH ALABAMA
Entity Type:Organization
Organization Name:EYE SURGERY CENTER OF NORTH ALABAMA
Other - Org Name:SOUTHERN EYE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-533-0513
Mailing Address - Street 1:3501 MEMORIAL PKWY SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5319
Mailing Address - Country:US
Mailing Address - Phone:256-428-3937
Mailing Address - Fax:
Practice Address - Street 1:120 GOVERNORS DR SE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4320
Practice Address - Country:US
Practice Address - Phone:256-533-0315
Practice Address - Fax:256-533-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical