Provider Demographics
NPI:1982685400
Name:STEELE, ZACHARY B (OD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:B
Last Name:STEELE
Suffix:
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 1:133 CHALKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173
Mailing Address - Country:US
Mailing Address - Phone:205-655-4838
Mailing Address - Fax:205-655-6996
Practice Address - Street 1:133 CHALKVILLE RD
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173
Practice Address - Country:US
Practice Address - Phone:205-655-4838
Practice Address - Fax:205-655-6996
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-A57-TA-650152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51518287Medicare ID - Type Unspecified
ALU97151Medicare UPIN