Provider Demographics
NPI:1891936506
Name:MATTHEW S. JAMES O.D., P.C.
Entity Type:Organization
Organization Name:MATTHEW S. JAMES O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-936-9441
Mailing Address - Street 1:3172 DOLLY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5704
Mailing Address - Country:US
Mailing Address - Phone:205-936-9441
Mailing Address - Fax:
Practice Address - Street 1:3172 DOLLY RIDGE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-5704
Practice Address - Country:US
Practice Address - Phone:205-936-9441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-A52-TA-649152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009997065Medicaid
AL051527168Medicare PIN
AL009997065Medicaid