Provider Demographics
NPI:1588649032
Name:WEEKS, CHARLES CLARK (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CLARK
Last Name:WEEKS
Suffix:
Gender:M
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:PO BOX 1290
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-1290
Mailing Address - Country:US
Mailing Address - Phone:205-487-2860
Mailing Address - Fax:205-487-3886
Practice Address - Street 1:768 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-4710
Practice Address - Country:US
Practice Address - Phone:205-487-2860
Practice Address - Fax:205-487-3886
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-745152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510 58326OtherBLUECROSS BLUESHIELD
AL0701600001OtherPALMETTO GOVERNMENT BENEF
ALP00056808OtherRAILROAD MEDICARE
AL000058326Medicaid
AL510 58326OtherBLUECROSS BLUESHIELD