Provider Demographics
NPI:1356312045
Name:MCROY, RICA P (OD)
Entity Type:Individual
Prefix:MRS
First Name:RICA
Middle Name:P
Last Name:MCROY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 BALMORAL DR SW STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6402
Mailing Address - Country:US
Mailing Address - Phone:256-801-0099
Mailing Address - Fax:256-533-1369
Practice Address - Street 1:4030 BALMORAL DR SW STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-801-0099
Practice Address - Fax:256-533-1369
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-847-TA-353152W00000X
ALS847TA353152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529603830Medicaid
AL512-9179OtherBLUE CROSS
AL529603830Medicaid
AL510-26670OtherBLUECROSS BLUE SHIELD PRO
U62826Medicare UPIN