Provider Demographics
NPI:1609227578
Name:LOCY, MARISSA KAYE (OD)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:KAYE
Last Name:LOCY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 830941
Mailing Address - Street 2:MSC 559
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0941
Mailing Address - Country:US
Mailing Address - Phone:205-325-8372
Mailing Address - Fax:205-325-8270
Practice Address - Street 1:700 18TH ST S
Practice Address - Street 2:STE 601
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1856
Practice Address - Country:US
Practice Address - Phone:205-325-8620
Practice Address - Fax:205-325-8333
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSD52TAA51152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist