Provider Demographics
NPI:1891103875
Name:MCGUIRE, MALLORY ELIZABETH (OD)
Entity type:Individual
Prefix:MS
First Name:MALLORY
Middle Name:ELIZABETH
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:OD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:SCHAEFFER EYE CENTER
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1376
Mailing Address - Country:US
Mailing Address - Phone:205-661-2080
Mailing Address - Fax:205-661-2085
Practice Address - Street 1:1686 MONTGOMERY HIGHWAY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-979-2020
Practice Address - Fax:205-978-6487
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSD24152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist