Organization
DR. BRIAN R. PETTIE EYECARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN ROLAND PETTIE O.D. (OWNER)
(205) 833-3171
Entity
Organization
Contact information
Practice address
9248 PARKWAY E, BIRMINGHAM, AL 35206-1509
(205) 833-3171
(205) 833-3059
Mailing address
9248 PARKWAY E, BIRMINGHAM, AL 35206-1509
(205) 833-3171
(205) 833-3059
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-A54-TA-634
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51532635
BCBS AL IRONDALE LOCATION
AL
01
—
51538863
BCBS AL ROEBUCK LOCATION
AL
01
—
U99431
VIVA
AL
Enumeration date
07/04/2007
Last updated
08/22/2020
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