# WYATT- KIRKPATRICK EYE MD ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992841886
- **Authorized official:** STEPHANIE MIMS (OFFICE MANAGER)
- **Authorized official phone:** (334) 874-3403

## Contact information

- **Practice address:** 2 OFFICE PARK CIR, SELMA, AL 36701-6538
- **Practice address phone:** (334) 872-3403
- **Practice address fax:** (334) 872-3405
- **Mailing address:** 2 OFFICE PARK CIR, SELMA, AL 36701-6538
- **Mailing address phone:** (334) 872-3403
- **Mailing address fax:** (334) 872-3405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | S-B10-TA-704 | AL | — |
| 207W00000X | Ophthalmology Physician | 20641 | AL | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 04/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000002044 | — | AL |
| 05 | — | 009937627 | — | AL |
| 05 | — | 009976795 | — | AL |
| 01 | — | 051002044 | BCBS | AL |
| 01 | — | 051525773 | BCBS | AL |
| 01 | — | 051535830 | DR. MUTAI BCBS | AL |
| 01 | — | 118255 | EYEMED | — |
| 01 | — | 180035890 | RAILROAD MEDICARE | — |
| 01 | — | G68704 | UPIN | — |
| 01 | — | P00437321 | RAILROAD MEDICARE | — |
| 01 | — | V06937 | UPIN | — |