Provider Demographics
NPI:1154361251
Name:MARBOURG, JAMES W (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:MARBOURG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:250 STATE FARM PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7181
Mailing Address - Country:US
Mailing Address - Phone:205-943-4600
Mailing Address - Fax:205-943-4688
Practice Address - Street 1:250 STATE FARM PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7181
Practice Address - Country:US
Practice Address - Phone:205-943-4600
Practice Address - Fax:205-943-4688
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS395TA054152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-10423OtherBC-15255 HIGHWAY 43, RUSSELLVILLE
AL510-10411OtherBC-1207 EAST FORREST STREET, SUITE H, ATHENS
AL515-04463OtherBC-2015 RAINBOW DRIVE, GADSDEN
ALT68974OtherVIVA
410046814OtherRAILROAD MEDICARE
AL510-10408OtherBC-1979 ALABAMA HIGHWAY 157, CULLMAN
AL510-10409OtherBC-250 OAKHILL ROAD, SUITE A, JASPER
AL510-10414OtherBC-2603 MOODY PARKWAY, MOODY
AL510-10464OtherBC-425 E. 10TH STREET, SUITE C, ANNISTON
AL510-10473OtherBC-2349 DANVILLE ROAD SW, SUITE 410, DECATUR
AL510-76383OtherBC-155 MEDICAL STREET, SNEAD
AL009977410Medicaid
AL051504462OtherBLUE CROSS BLUE SHIELD
AL22-10235OtherUNITED HEALTHCARE
AL510-10413OtherBC-715 SNOW STREET, OXFORD
AL510-10483OtherBC-106 WEST JACKSON STREET, BREWTON
AL510-10490OtherBC-2003 MEDICAL CENTER DRIVE, BAY MINETTE
ALP00023966OtherRAILROAD MEDICARE UABSO
AL9921675OtherMEDICAID UABSO
AL510-10450OtherBC-1900 11TH AVENUE, HALEYVILLE
AL510-10462OtherBC-300 EAST STREET NORTH, SUITE F, TALLADEGA
AL510-10477OtherBC-823 6TH AVENUE SE, DECATUR
AL510-76604OtherBC-308 6TH STREET SOUTH, SUITE 105, ONEONTA
AL515-04462OtherBC-3290 DAUPHIN STREET, SUITE 401, MOBILE
AL510-10484OtherBC-1811 HAND AVENUE, BAY MINETTE
AL1154361251Medicare PIN
AL51515572OtherBCBS UABSO
AL051504463OtherBLUE CROSS BLUE SHIELD
T68974Medicare UPIN
AL1154361251Medicaid
AL051504462Medicaid
AL51553597Medicare PIN
AL051504462Medicare PIN
ALT68974OtherHEALTHSPRINGS OF ALABAMA
AL510-10459OtherBC-768 US HIGHWAY 43, WINFIELD
AL510-10470OtherBC-729 BATTLE STREET EAST, TALLADEGA
AL510-10491OtherBC-3016 SOUTH ALABAMA AVENUE, MONROEVILLE
AL510-10424OtherBC-1723 COGSWELL AVENUE, PELL CITY
ALT68974OtherVIVA UABSO
AL510-10463OtherBC-418 MARTLING ROAD, ALBERTVILLE
ALT68974OtherVIVA MEDICARE
AL510-10407OtherBC-1150 EAGLETREE LANE SE, HUNTSVILLE
AL510-10417OtherBC-1195 MILITARY STREET SOUTH, HAMILTON
AL510-10448OtherBC-1825 TIN VALLEY CIRCLE, SUITE A, BIRMINGHAM
AL510-10454OtherBC-1925 MILITARY STREET SOUTH, HAMILTON
AL510-10455OtherBC-2010 PATTON CHAPEL ROAD, SUITE 102, BIRMINGHAM
AL510-10456OtherBC-3519 WATERMELON ROAD, NORTHPORT
AL510-10499OtherBC-7101 US HIGHWAY 90, DAPHNE
AL515-04462OtherBC-250 STATE FARM PARKWAY, BIRMINGHAM