Provider Demographics
NPI:1013000595
Name:CUMMINGS, WENDY JEANETTE (OD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JEANETTE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 FOREST LAKES DRIVE
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147
Mailing Address - Country:US
Mailing Address - Phone:205-602-1448
Mailing Address - Fax:256-234-4915
Practice Address - Street 1:2643 HIGHWAY 280 WEST
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010
Practice Address - Country:US
Practice Address - Phone:256-234-3962
Practice Address - Fax:256-234-4915
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSA04TA-552152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist