Provider Demographics
NPI:1639351372
Name:ALABAMA EYE CLINIC PC
Entity Type:Organization
Organization Name:ALABAMA EYE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHNORBUS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-362-4872
Mailing Address - Street 1:109 EAST COOSA STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2546
Mailing Address - Country:US
Mailing Address - Phone:256-362-4872
Mailing Address - Fax:
Practice Address - Street 1:109 COOSA STREET EAST
Practice Address - Street 2:SUITE A
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2546
Practice Address - Country:US
Practice Address - Phone:256-362-4872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51039940OtherBCBS AL
AL529801330Medicaid
ALJ650Medicare PIN
AL529801330Medicaid
AL1201480001Medicare NSC