Provider Demographics
NPI:1881618403
Name:BAY EYES SURGERY CENTER
Entity type:Organization
Organization Name:BAY EYES SURGERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRAVLEE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:251-990-3937
Mailing Address - Street 1:PO BOX 2020
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-2020
Mailing Address - Country:US
Mailing Address - Phone:251-990-3937
Mailing Address - Fax:251-990-9990
Practice Address - Street 1:411 NORTH SECTION STREET
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532
Practice Address - Country:US
Practice Address - Phone:251-990-3937
Practice Address - Fax:251-990-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12947261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051557682Medicaid
2721198OtherUNITED HEALTHCARE
AL510-04612OtherBLUE CROSS BLUE SHIEDL OF ALABAMA
AL51557682Medicare PIN