Provider Demographics
NPI:1770519050
Name:C.D. DENNEY & ASSOCIATES
Entity type:Organization
Organization Name:C.D. DENNEY & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARLA
Authorized Official - Middle Name:HARGROVE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-793-2633
Mailing Address - Street 1:151 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1625
Mailing Address - Country:US
Mailing Address - Phone:334-793-2633
Mailing Address - Fax:334-794-1626
Practice Address - Street 1:151 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1625
Practice Address - Country:US
Practice Address - Phone:334-793-2633
Practice Address - Fax:334-794-1626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL252152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000811005Medicaid
AL000811005Medicaid
ALT69117Medicare UPIN
ALT68981Medicare UPIN
ALU71361Medicare UPIN
ALT68946Medicare UPIN
ALU01855Medicare UPIN
D912Medicare PIN
ALT69011Medicare UPIN
ALT69179Medicare UPIN
0167370001Medicare NSC