Provider Demographics
NPI:1497765721
Name:EYE CENTER SURGEONS & ASSOC LLC
Entity Type:Organization
Organization Name:EYE CENTER SURGEONS & ASSOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-705-3937
Mailing Address - Street 1:401 MERIDIAN ST N
Mailing Address - Street 2:200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4720
Mailing Address - Country:US
Mailing Address - Phone:256-705-3937
Mailing Address - Fax:
Practice Address - Street 1:401 MERIDIAN ST N
Practice Address - Street 2:200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4720
Practice Address - Country:US
Practice Address - Phone:256-705-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000008502OtherMEDICARE PROVIDER
000009396OtherMEDICARE PROVIDER
AL7077960001OtherMEDICARE
000008474OtherMEDICARE PROVIDER
000009077OtherMEDICARE PROVIDER
051507443OtherMEDICARE PROVIDER
000009077OtherMEDICARE PROVIDER
000008474OtherMEDICARE PROVIDER
E67744Medicare UPIN
G05266Medicare UPIN