Provider Demographics
NPI:1710053053
Name:CUMMINGS, CHARLES L
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:L
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 COLISEUM BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-2712
Mailing Address - Country:US
Mailing Address - Phone:334-272-2115
Mailing Address - Fax:334-270-8383
Practice Address - Street 1:306 COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-2712
Practice Address - Country:US
Practice Address - Phone:334-272-2115
Practice Address - Fax:334-270-8383
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL09658156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician