Provider Demographics
NPI:1790954543
Name:JAMES L DRIGGARS OD PA
Entity Type:Organization
Organization Name:JAMES L DRIGGARS OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:DRIGGARS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-755-2296
Mailing Address - Street 1:PO BOX 1307
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35046
Mailing Address - Country:US
Mailing Address - Phone:205-755-2296
Mailing Address - Fax:205-755-9378
Practice Address - Street 1:109 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2331
Practice Address - Country:US
Practice Address - Phone:205-755-2296
Practice Address - Fax:205-755-9378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0691480001Medicare NSC