1851484596 NPI number — VESTAVIA EYE CARE, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851484596 NPI number — VESTAVIA EYE CARE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VESTAVIA EYE CARE, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851484596
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2531 ROCKY RIDGE RD
Provider Second Line Business Mailing Address:
STE 116
Provider Business Mailing Address City Name:
VESTAVIA HILLS
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-978-4088
Provider Business Mailing Address Fax Number:
205-978-4085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2531 ROCKY RIDGE RD
Provider Second Line Business Practice Location Address:
STE 116
Provider Business Practice Location Address City Name:
VESTAVIA HILLS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-978-4088
Provider Business Practice Location Address Fax Number:
205-978-4085
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ESSINGER
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
205-978-4088

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  S770TA218 S985TA558 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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