Provider Demographics
NPI:1336432061
Name:E NEAL IRWIN OD INC
Entity Type:Organization
Organization Name:E NEAL IRWIN OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:E.
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-733-9311
Mailing Address - Street 1:3608 CHARLESTON LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4887
Mailing Address - Country:US
Mailing Address - Phone:205-733-9311
Mailing Address - Fax:205-733-9581
Practice Address - Street 1:2780 JOHN HAWKINS PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4001
Practice Address - Country:US
Practice Address - Phone:205-733-9311
Practice Address - Fax:205-733-9581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS923TA491152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000045866Medicare PIN