Organization
SOUTHERN RETINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MORRIS M.D. (PRESIDENT/OWNER)
(205) 943-4600
Entity
Organization
Contact information
Practice address
250 STATE FARM PKWY, BIRMINGHAM, AL 35209-7181
(205) 943-4600
(205) 943-4688
Mailing address
250 STATE FARM PKWY, BIRMINGHAM, AL 35209-7181
(205) 943-4600
(205) 943-4688
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ9053
RR MEDICARE PGBA
AL
Enumeration date
07/06/2006
Last updated
08/22/2020
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