Provider Demographics
NPI:1609842459
Name:HERRINGTON, AMY H (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:H
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 ACTON RD STE 161
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2939
Mailing Address - Country:US
Mailing Address - Phone:205-202-9607
Mailing Address - Fax:205-337-0843
Practice Address - Street 1:2409 ACTON RD STE 161
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2939
Practice Address - Country:US
Practice Address - Phone:205-202-9607
Practice Address - Fax:205-337-0843
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-682-TA-193152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009934554Medicaid
ALS-682-TA-193OtherAL BOARD OF OPTOMETRY
ALS-682-TA-193OtherAL BOARD OF OPTOMETRY
AL000058360Medicare ID - Type UnspecifiedMEDICARE
ALS-682-TA-193OtherAL BOARD OF OPTOMETRY