Provider Demographics
NPI: | 1033159033 |
---|---|
Name: | HELTON, AMANDA JILL ESSLINGER (OD) |
Entity Type: | Individual |
Prefix: | |
First Name: | AMANDA |
Middle Name: | JILL ESSLINGER |
Last Name: | HELTON |
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: | 250 STATE FARM PKWY |
Mailing Address - Street 2: | |
Mailing Address - City: | BIRMINGHAM |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35209-7181 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 205-943-4600 |
Mailing Address - Fax: | 205-943-4688 |
Practice Address - Street 1: | 250 STATE FARM PKWY |
Practice Address - Street 2: | |
Practice Address - City: | BIRMINGHAM |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35209-7181 |
Practice Address - Country: | US |
Practice Address - Phone: | 205-943-4600 |
Practice Address - Fax: | 205-943-4688 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-07 |
Last Update Date: | 2020-01-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AL | S898TA466 | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AL | 510-10545 | Other | BC-1979 ALABAMA HWY 157, CULLMAN |
AL | 515-04881 | Other | BC-250 STATE FARM PKWY, BIRMINGHAM |
AL | 051504886 | Medicare PIN | |
410046816 | Other | RAILROAD MEDICARE | |
AL | 510-10573 | Other | BC-1825 TIN VALLEY CIRCLE, SUITE A, BIRMINGHAM |
U77471 | Medicare UPIN | ||
AL | 510-10556 | Other | BC-300 EAST STREET NORTH, SUITE F, TALLADEGA |
AL | 510-10572 | Other | BC-729 BATTLE STREET EAST, TALLADEGA |
AL | P00023965 | Other | RAILROAD MEDICARE UABSO |
AL | 009977400 | Medicaid | |
AL | 510-10555 | Other | BC-1723 COGSWELL AVENUE, PELL CITY |
AL | 510-10570 | Other | BC-155 MEDICAL STREET, SNEAD |
AL | 510-10574 | Other | BC-2603 MOODY PARKWAY, MOODY |
AL | 621856846 | Other | TRICARE |
AL | U77471 | Other | VIVA MEDICARE |
AL | 1033159033 | Medicare PIN | |
AL | 510-10567 | Other | BC-308 6TH STREET SOUTH, SUITE 105, ONEONTA |
AL | 510-10564 | Other | BC-425 E 10TH STREET, SUITE C, ANNISTON |
AL | 515-04886 | Other | BC-2015 RAINBOW DR, GADSDEN |
AL | 51515407 | Other | BCBS UABSO |
AL | U77471 | Other | VIVA UABSO |
AL | 051504886 | Medicaid | |
AL | 1033159033 | Medicaid | |
AL | 22-11009 | Other | UNITED HEALTHCARE |
AL | 510-10550 | Other | BC-715 SNOW STREET, OXFORD |
AL | 9921695 | Other | MEDICAID UABSO |
AL | 51515407 | Medicare PIN | |
AL | 510-10545 | Other | BC-1979 ALABAMA HWY 157, CULLMAN |
AL | 515-04881 | Other | BC-250 STATE FARM PKWY, BIRMINGHAM |
AL | U77471 | Other | VIVA |