Provider Demographics
NPI:1487160768
Name:VISION PLUS EYECARE DEKALB LLC
Entity type:Organization
Organization Name:VISION PLUS EYECARE DEKALB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:HABEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-638-6386
Mailing Address - Street 1:P.O. BOX 609
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986
Mailing Address - Country:US
Mailing Address - Phone:256-638-6386
Mailing Address - Fax:256-638-7360
Practice Address - Street 1:94 CHURCH AVENUE N
Practice Address - Street 2:
Practice Address - City:RAINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35986
Practice Address - Country:US
Practice Address - Phone:256-638-6386
Practice Address - Fax:256-638-7360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty