Provider Demographics
NPI:1487728218
Name:TUSCALOOSA OPHTHALMOLOGY, INC.
Entity type:Organization
Organization Name:TUSCALOOSA OPHTHALMOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-227-2600
Mailing Address - Street 1:535 JACK WARNER PKWY NE STE B1
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5715
Mailing Address - Country:US
Mailing Address - Phone:205-556-2121
Mailing Address - Fax:205-554-0152
Practice Address - Street 1:535 JACK WARNER PKWY NE STE B1
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5715
Practice Address - Country:US
Practice Address - Phone:205-556-2121
Practice Address - Fax:205-554-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529202430Medicaid
AL529202430Medicaid