Provider Demographics
NPI:1023630985
Name:SOUTHERN VISION EYE CARE LLC
Entity type:Organization
Organization Name:SOUTHERN VISION EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-625-5520
Mailing Address - Street 1:230 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-1734
Mailing Address - Country:US
Mailing Address - Phone:205-625-5520
Mailing Address - Fax:
Practice Address - Street 1:230 1ST AVE E
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-1734
Practice Address - Country:US
Practice Address - Phone:205-625-5520
Practice Address - Fax:205-810-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty