Provider Demographics
NPI:1871660332
Name:ALFORD, JULIAN R JR (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:R
Last Name:ALFORD
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1368 E CALL ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2804
Mailing Address - Country:US
Mailing Address - Phone:850-878-3191
Mailing Address - Fax:850-878-3192
Practice Address - Street 1:1368 E CALL ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2804
Practice Address - Country:US
Practice Address - Phone:850-878-3191
Practice Address - Fax:850-878-3192
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL1066152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03620OtherDAVIS VISION
FL19804OtherBLUE CROSS BLUE SHIELD
FL19804Medicare PIN
FLT84046Medicare UPIN
FL03620OtherDAVIS VISION