Cherokee Eye Clinic Co, Inc

Organization Active NPI Optometrist · Centre, AL

NPI 1265040273 · NPPES record last updated Jul 15, 2020

Key facts

NPI
1265040273
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
CHEROKEE EYE CLINIC CO, INC
Practice address
280 W Main St
Centre, AL 35960-1326
Phone
(256) 927-4030
Fax
(256) 927-2586
NPI assigned
Jul 15, 2020
Organization subpart
No

Authorized official

Name
Dr. James Randall McKissick II, OD
Title
Owner
Phone
(256) 484-2151

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20201118002596 AL Part B Supplier - Clinic/Group Practice 5092126276 Receives reassigned benefits from 2 practitioners
Practice locations: Centre, AL

National Provider Directory

Locations

280 W Main St
Centre, AL 35960
Phone (256) 927-4030

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

280 W Main St
Centre, AL 35960-1326

Mailing address

280 W Main St
Centre, AL 35960-1326
Phone (256) 927-4030

Other providers in Centre, AL

All providers in Centre, AL · Optometrist in Alabama

Sources for this page

Verify at the official NPI Registry.