Provider Demographics
NPI:1740399013
Name:ALABAMA EYE CENTER, PC
Entity Type:Organization
Organization Name:ALABAMA EYE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABERNATHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-221-4705
Mailing Address - Street 1:20 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 20
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3464
Mailing Address - Country:US
Mailing Address - Phone:205-221-4705
Mailing Address - Fax:205-221-0489
Practice Address - Street 1:20 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 20
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3464
Practice Address - Country:US
Practice Address - Phone:205-221-4705
Practice Address - Fax:205-221-0489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCM7606Medicare ID - Type UnspecifiedRR MCR GROUP PAYEE #
ALD092Medicare ID - Type UnspecifiedGROUP PAYEE NUMBER