Provider Demographics
NPI:1184680647
Name:ALABAMA EYE SURGERY PC
Entity Type:Organization
Organization Name:ALABAMA EYE SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:SHELBY
Authorized Official - Last Name:EICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-787-1411
Mailing Address - Street 1:PO BOX 10992
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-0992
Mailing Address - Country:US
Mailing Address - Phone:205-787-1411
Mailing Address - Fax:205-787-2603
Practice Address - Street 1:801 PRINCETON AVE SW
Practice Address - Street 2:STE 530
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1310
Practice Address - Country:US
Practice Address - Phone:205-787-1411
Practice Address - Fax:205-787-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529921660Medicaid
ALG042OtherBLUE CROSS OF ALABAMA
ALDC1578OtherRAILROAD MEDICARE GROUP
ALK113Medicare PIN
ALDC1578OtherRAILROAD MEDICARE GROUP