Provider Demographics
NPI:1750601316
Name:DOSS, REBECCA J (OD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:J
Last Name:DOSS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:REBECCA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3240 EDWARDS LAKE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3117
Mailing Address - Country:US
Mailing Address - Phone:205-949-2020
Mailing Address - Fax:205-949-1400
Practice Address - Street 1:3240 EDWARDS LAKE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3117
Practice Address - Country:US
Practice Address - Phone:205-949-2020
Practice Address - Fax:205-949-1400
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C28TA-851152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I411884Medicare PIN