Provider Demographics
NPI:1700879145
Name:BEDSOLE, JAMES W (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:BEDSOLE
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 1:1723 COGSWELL AVE
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-1646
Mailing Address - Country:US
Mailing Address - Phone:205-884-2020
Mailing Address - Fax:205-338-8840
Practice Address - Street 1:2020 MARTIN ST S
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128-2326
Practice Address - Country:US
Practice Address - Phone:205-884-2020
Practice Address - Fax:205-338-8840
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS404-TA-011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL45072OtherBLUECROSS PMD
AL000045072Medicaid
AL000045072Medicare PIN
AL000045072Medicaid
AL1272090001Medicare NSC
T69127Medicare UPIN