Provider Demographics
NPI:1992807259
Name:ALABAMA VISION CENTER, LLC
Entity type:Organization
Organization Name:ALABAMA VISION CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
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 1:790 MONTCLAIR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1966
Mailing Address - Country:US
Mailing Address - Phone:205-592-3911
Mailing Address - Fax:205-592-3537
Practice Address - Street 1:790 MONTCLAIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1966
Practice Address - Country:US
Practice Address - Phone:205-592-3911
Practice Address - Fax:205-592-3537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2024-10-25
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
AL529932906Medicaid
ALN044OtherBCBS
ALDG4963Medicare PIN
ALN044OtherBCBS
AL529932906Medicaid