Provider Demographics
NPI:1952343659
Name:SAMFORD, ABNOUS ABBEY (OD)
Entity Type:Individual
Prefix:DR
First Name:ABNOUS
Middle Name:ABBEY
Last Name:SAMFORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ABNOUS
Other - Middle Name:ANNA
Other - Last Name:ABBEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2801 HIGHWAY 150
Mailing Address - Street 2:SUITE 149M
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4007
Mailing Address - Country:US
Mailing Address - Phone:205-985-7640
Mailing Address - Fax:205-985-7638
Practice Address - Street 1:2801 HIGHWAY 150
Practice Address - Street 2:SUITE 149M
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4007
Practice Address - Country:US
Practice Address - Phone:205-985-7640
Practice Address - Fax:205-985-7638
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSA79TA665152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALV03891OtherVIVA
AL009983385Medicaid
AL51526686OtherBCBS
AL7656808OtherAETNA
ALV03891OtherHEALTHSPRING
AL51535244OtherBCBS
AL009938092Medicaid
AL51526686OtherBCBS
AL51535244OtherBCBS
AL009983385Medicaid