Donna L. Lee OD ,D/B/a Talladega Family Optical

Primary specialty

OptometristTaxonomy code 152W00000X

License

ST410TA319 Issued in AL

Legal business name

DONNA L. LEE OD ,D/B/A TALLADEGA FAMILY OPTICAL

Practice address

112 Court SQ S
Talladega, AL 35160-2461

Phone

(256) 362-9595

Fax

(256) 362-0707

NPI assigned

Jan 10, 2007

Organization subpart

No

Name

Ms. Deborah Denson Edwards

Title

Administrator

Phone

(256) 878-9027

• Donna L. Lee OD ,Talladega Family Optical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2008.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1003965633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351610457",
            "telephone_number": "256-362-9595",
            "fax_number": "256-362-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 COURT SQ S",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351602461",
            "telephone_number": "256-362-9595",
            "fax_number": "256-362-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA L. LEE OD ,D/B/A TALLADEGA FAMILY OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "DENSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-878-9027",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "ST410TA319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-33852",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936628",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Donna L. Lee OD ,Talladega Family Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.