| Daryl G. Custred, O.d., L.l.c. | |
|
1499 N Airport Rd, Jasper, AL 35504-8882 | |
| (205) 221-3721 | |
| (205) 221-2748 |
| Full Name | Daryl G. Custred, O.d., L.l.c. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1499 N Airport Rd, Jasper, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891972352 | NPI | - | NPPES |
| DN9352 | Other | AL | RAILROAD MEDICARE |
| 103021 | Other | AL | ALABAMA MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | S-505-TA-126 (Alabama) | Primary |
| Provider Name | Daryl G Custred |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215047097 PECOS PAC ID: 8325941313 Enrollment ID: I20040128000600 |
| Mailing Address | Practice Location Address |
|---|---|
| Daryl G. Custred, O.d., L.l.c. 1499 N Airport Rd, Jasper, AL 35504-8882 Ph: (205) 221-3721 | Daryl G. Custred, O.d., L.l.c. 1499 N Airport Rd, Jasper, AL 35504-8882 Ph: (205) 221-3721 |
Gary E Roquemore, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 904 Highway 78 E, Jasper, AL 35501 Phone: 205-221-6718 Fax: 205-221-7578 | |
David T Wesley, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 302 Oakhill Rd, Jasper, AL 35504 Phone: 205-221-7779 Fax: 205-221-8742 | |
Dr. Daryl G Custred, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1499 N Airport Rd, Jasper, AL 35504 Phone: 205-221-3721 Fax: 205-221-2748 | |
Dr. Taibele Karen Wesley, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 205 Oakhill Rd, Ste A, Jasper, AL 35504 Phone: 205-221-7779 Fax: 205-221-8742 | |
Ferris Eye Clinic Optometrist Medicare: Medicare Enrolled Practice Location: 309 19th St E, Jasper, AL 35501 Phone: 205-221-2033 Fax: 205-221-2035 | |
Wesley Eye Center Optometrist Medicare: Medicare Enrolled Practice Location: 302 Oakhill Rd, 205 Oakhill Rd, Jasper, AL 35504 Phone: 205-221-7779 Fax: 205-221-8749 | |
Andrea D Sims Od Pc Optometrist Medicare: Medicare Enrolled Practice Location: 1320 Highway 78 E, Jasper, AL 35501 Phone: 205-221-3937 Fax: 205-221-4417 |