Provider Demographics
NPI:1215918925
Name:APPLEBY, DORIS ANN (OD)
Entity type:Individual
Prefix:DR
First Name:DORIS
Middle Name:ANN
Last Name:APPLEBY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5783 CARMICHAEL PKWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2353
Mailing Address - Country:US
Mailing Address - Phone:334-271-2020
Mailing Address - Fax:334-271-2042
Practice Address - Street 1:5783 CARMICHAEL PKWY
Practice Address - Street 2:MONTGOMERY OPTOMETRIC CLINIC, PA
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2353
Practice Address - Country:US
Practice Address - Phone:334-271-2020
Practice Address - Fax:334-271-2042
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS385TA280152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000059453Medicaid
AL000059453Medicaid
AL59453Medicare PIN