Provider Demographics
NPI:1487365987
Name:INVISION OPHTHALMOLOGY P.C.
Entity type:Organization
Organization Name:INVISION OPHTHALMOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MGR
Authorized Official - Prefix:
Authorized Official - First Name:TALIESHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-514-8085
Mailing Address - Street 1:2100 DEVEREUX CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2558
Mailing Address - Country:US
Mailing Address - Phone:205-879-2221
Mailing Address - Fax:
Practice Address - Street 1:2615 MCFARLAND BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-1803
Practice Address - Country:US
Practice Address - Phone:205-556-4180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INVISION OPHTHALMOLOGY P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1236030Medicaid