Provider Demographics
NPI:1467606434
Name:MONTGOMERY EYE CARE ASSOCIATES,LLC
Entity Type:Organization
Organization Name:MONTGOMERY EYE CARE ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-260-8511
Mailing Address - Street 1:262 MITYLENE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3548
Mailing Address - Country:US
Mailing Address - Phone:334-260-8511
Mailing Address - Fax:334-260-8755
Practice Address - Street 1:262 MITYLENE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3548
Practice Address - Country:US
Practice Address - Phone:334-260-8511
Practice Address - Fax:334-260-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty