Provider Demographics
NPI:1649448192
Name:20/20 EYE CARE
Entity type:Organization
Organization Name:20/20 EYE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHEFFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:334-792-2020
Mailing Address - Street 1:2464 W MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-6411
Mailing Address - Country:US
Mailing Address - Phone:334-792-2020
Mailing Address - Fax:334-712-2020
Practice Address - Street 1:2464 W MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-6411
Practice Address - Country:US
Practice Address - Phone:334-792-2020
Practice Address - Fax:334-712-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS422TA173332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0174650001Medicare NSC