Provider Demographics
NPI:1982686572
Name:EILAND, SUSAN HORTON (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:HORTON
Last Name:EILAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 10TH AVENUE SOUTH
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1250
Mailing Address - Country:US
Mailing Address - Phone:205-933-2340
Mailing Address - Fax:
Practice Address - Street 1:2700 10TH AVENUE SOUTH
Practice Address - Street 2:SUITE 404
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1250
Practice Address - Country:US
Practice Address - Phone:205-933-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4320152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51006144OtherBCBS
ALC75157Medicare UPIN
AL000006144Medicare ID - Type UnspecifiedMEDICARE