Provider Demographics
NPI:1225067697
Name:STAUP, JAMES C III (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:STAUP
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6838 HIGHWAY 431 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-7200
Mailing Address - Country:US
Mailing Address - Phone:256-534-3900
Mailing Address - Fax:256-534-6994
Practice Address - Street 1:6838 HIGHWAY 431 S
Practice Address - Street 2:SUITE A
Practice Address - City:OWENS CROSS ROADS
Practice Address - State:AL
Practice Address - Zip Code:35763-7200
Practice Address - Country:US
Practice Address - Phone:256-534-3900
Practice Address - Fax:256-534-6994
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-783-TA-295152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000058571Medicaid
DN3541OtherMEDICARE RAILROAD CARRIER
DN3541OtherMEDICARE RAILROAD CARRIER
AL000058571Medicaid