Provider Demographics
NPI:1114067741
Name:JAMES H. POOLE & ASSOCIATES, O.D., P.C.
Entity Type:Organization
Organization Name:JAMES H. POOLE & ASSOCIATES, O.D., P.C.
Other - Org Name:FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-329-8400
Mailing Address - Street 1:1120 AIRPORT DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3436
Mailing Address - Country:US
Mailing Address - Phone:256-329-8400
Mailing Address - Fax:256-329-8200
Practice Address - Street 1:1120 AIRPORT DR
Practice Address - Street 2:SUITE 104
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3436
Practice Address - Country:US
Practice Address - Phone:256-329-8400
Practice Address - Fax:256-329-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS641-TA-157152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529906340Medicaid
AL529906340Medicaid
AL000095094Medicare PIN
ALI548Medicare PIN
ALU85424Medicare UPIN
AL0348120001Medicare NSC