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Individual

JIMMY D. BARTLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1716 UNIVERSITY BLVD, HPB G080A, BIRMINGHAM, AL 35294-0010
(205) 975-2020
(205) 934-6755
Mailing address
1716 UNIVERSITY BLVD, HPB GO80A, BIRMINGHAM, AL 35294-0010
(205) 934-4748
(205) 934-6755

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T-29-TA-008
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000059862
AL
05
08304066
MS
05
1585904
LA
01
1716A 636005396
VISION SERVICES PLAN
01
51059862
BLUE CROSS BLUE SHIELD OF
AL
01
T69119
VIVA HEALTHCARE
AL
Enumeration date
08/04/2006
Last updated
07/01/2010
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