Provider Demographics
NPI:1942712005
Name:SPARKMAN EYE CARE
Entity Type:Organization
Organization Name:SPARKMAN EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ISFAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-797-3606
Mailing Address - Street 1:1200 PRESIDENTS WAY SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-3673
Mailing Address - Country:US
Mailing Address - Phone:256-797-3606
Mailing Address - Fax:
Practice Address - Street 1:2597 SPARKMAN DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3868
Practice Address - Country:US
Practice Address - Phone:256-512-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C19-TA-840152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty