Provider Demographics
NPI:1881855229
Name:D & K EYEWEAR
Entity Type:Organization
Organization Name:D & K EYEWEAR
Other - Org Name:BELL ROAD EYEWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:334-386-2751
Mailing Address - Street 1:2567 BELL ROAD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4369
Mailing Address - Country:US
Mailing Address - Phone:334-386-2751
Mailing Address - Fax:334-386-2754
Practice Address - Street 1:2567 BELL ROAD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-4369
Practice Address - Country:US
Practice Address - Phone:334-386-2751
Practice Address - Fax:334-386-2754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C59-TA-897152W00000X, 156FX1800X
AL446199156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL131425Medicaid