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Organization

BAY EYES SPECTACULAR, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH FRANK GRAVLEE JR. MD (OWNER)
(251) 990-9999
Entity
Organization

Contact information

Practice address
411 N SECTION ST, FAIRHOPE, AL 36532-2649
(251) 990-9999
(251) 990-9990
Mailing address
411 N SECTION ST, FAIRHOPE, AL 36532-2649
(251) 990-9999
(251) 990-9990

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0527980001
MEDICARE LEGACY IDENTIFIER
AL
01
510-58327
BLUE CROSS BLUE SHIELD
AL
Enumeration date
03/29/2007
Last updated
07/21/2022
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