Provider Demographics
NPI:1629205232
Name:ALI, EMMA-CATHERINE HIX (OD)
Entity Type:Individual
Prefix:DR
First Name:EMMA-CATHERINE
Middle Name:HIX
Last Name:ALI
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:PO BOX 1789
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24008-1789
Mailing Address - Country:US
Mailing Address - Phone:540-344-4000
Mailing Address - Fax:540-342-4373
Practice Address - Street 1:707 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-5100
Practice Address - Country:US
Practice Address - Phone:540-344-4000
Practice Address - Fax:540-343-5996
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001837152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA020371W99Medicare PIN