Provider Demographics
NPI:1043554363
Name:NOWVISION EYE CARE LLC
Entity Type:Organization
Organization Name:NOWVISION EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:JASPER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-777-5572
Mailing Address - Street 1:2226 1ST AVE S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2333
Mailing Address - Country:US
Mailing Address - Phone:205-777-5572
Mailing Address - Fax:205-777-5576
Practice Address - Street 1:2226 1ST AVE S
Practice Address - Street 2:SUITE 103
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2333
Practice Address - Country:US
Practice Address - Phone:205-777-5572
Practice Address - Fax:205-777-5576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C60-TA-898152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G703487OtherMEDICARE PTAN