Provider Demographics
NPI:1588844377
Name:TERRY L BONDS,OD,PC
Entity Type:Organization
Organization Name:TERRY L BONDS,OD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-435-9453
Mailing Address - Street 1:601 PELHAM RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-2731
Mailing Address - Country:US
Mailing Address - Phone:256-743-5945
Mailing Address - Fax:256-435-9485
Practice Address - Street 1:601 PELHAM RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-2731
Practice Address - Country:US
Practice Address - Phone:256-435-9453
Practice Address - Fax:256-435-9485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS491TA015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALT69137Medicare UPIN
AL0274330002Medicare NSC
ALH540Medicare PIN