Provider Demographics
NPI:1962518803
Name:EYE CARE ALABAMA INC
Entity type:Organization
Organization Name:EYE CARE ALABAMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:MOHON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-447-6413
Mailing Address - Street 1:801 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:AL
Mailing Address - Zip Code:36272-6632
Mailing Address - Country:US
Mailing Address - Phone:256-447-6413
Mailing Address - Fax:256-447-6443
Practice Address - Street 1:801 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:AL
Practice Address - Zip Code:36272-6632
Practice Address - Country:US
Practice Address - Phone:256-447-6413
Practice Address - Fax:256-447-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS917TA456152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTAN K991Medicare PIN