Provider Demographics
NPI:1366484941
Name:ALABAMA OPHTHALMOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ALABAMA OPHTHALMOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ELSAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-930-0700
Mailing Address - Street 1:1000 19TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4804
Mailing Address - Country:US
Mailing Address - Phone:205-930-0700
Mailing Address - Fax:205-930-9127
Practice Address - Street 1:1000 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-4804
Practice Address - Country:US
Practice Address - Phone:205-930-0700
Practice Address - Fax:205-930-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528400500Medicaid
AL528400500Medicaid