| |
166 Lindberg Ave, Atmore, AL 36502-3206 | |
(251) 368-8767 | |
(251) 368-4565 |
Full Name | |
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Type | Facility |
Speciality | Exclusive Provider Organization |
Location | 166 Lindberg Ave, Atmore, Alabama |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467504100 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
302F00000X | Exclusive Provider Organization | S486TA041 (Alabama) | Primary |
Provider Name | Stephen M Gross |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1831112317 PECOS PAC ID: 5294793568 Enrollment ID: I20050103000916 |
Provider Name | David J Helton |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467473835 PECOS PAC ID: 9436100237 Enrollment ID: I20050209000663 |
Provider Name | Ashley Mckain Ott |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1215290689 PECOS PAC ID: 3476863275 Enrollment ID: I20151106001307 |
Provider Name | Troy Enfinger |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1659800829 PECOS PAC ID: 2567728900 Enrollment ID: I20171117000881 |
Mailing Address | Practice Location Address |
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166 Lindberg Ave, Atmore, AL 36502-3206 Ph: (251) 368-8767 | 166 Lindberg Ave, Atmore, AL 36502-3206 Ph: (251) 368-8767 |