Provider Demographics
NPI:1164675617
Name:NORTON AVENUE EYE CLINIC
Entity Type:Organization
Organization Name:NORTON AVENUE EYE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-207-1277
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0007
Mailing Address - Country:US
Mailing Address - Phone:256-207-1277
Mailing Address - Fax:256-891-7855
Practice Address - Street 1:301 S NORTON AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-3433
Practice Address - Country:US
Practice Address - Phone:256-207-1277
Practice Address - Fax:256-891-7855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBERTVILLE FAMILY OPTICAL, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-410-TA-319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty