Organization
TALLADEGA OPTICAL DISPENSARY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALID L KHAN M.D. (OWNER)
(256) 362-1590
Entity
Organization
Contact information
Practice address
216 BATTLE ST E, TALLADEGA, AL 35160-2420
(256) 761-1889
(256) 362-1540
Mailing address
216 BATTLE ST E, TALLADEGA, AL 35160-2420
(256) 761-1889
(256) 362-1540
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51512981
BCBS
AL
Enumeration date
01/17/2007
Last updated
08/22/2020
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