Provider Demographics
NPI:1932592979
Name:AUBURN OPTICAL
Entity Type:Organization
Organization Name:AUBURN OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:REDUS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-294-6280
Mailing Address - Street 1:3021 FREDERICK RD
Mailing Address - Street 2:STE 4
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-7145
Mailing Address - Country:US
Mailing Address - Phone:334-705-8803
Mailing Address - Fax:334-705-8643
Practice Address - Street 1:3021 FREDERICK RD
Practice Address - Street 2:STE 4
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-7145
Practice Address - Country:US
Practice Address - Phone:334-705-8803
Practice Address - Fax:334-705-8643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR192TA861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty