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Organization

TENNESSEE RIVER EYE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK A KASSELS M.D. (OWNER PRESIDENT)
(256) 381-2020
Entity
Organization

Contact information

Practice address
1110 S. MONTGOMERY AVE, HELEN KELLER HOSPITAL CAMPUS, SHEFFIELD, AL 35660-6350
(256) 381-2020
(256) 381-7754
Mailing address
1110 S. MONTGOMERY AVE, HELEN KELLER HOSPITAL CAMPUS, SHEFFIELD, AL 35660-6350
(256) 381-2020
(256) 381-7754

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16162
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000008486
AL
01
000008486A
BLUE CROSS
AL
01
0810284
SPA
SC
01
168150600
COMMERCIAL
AL
01
180036556
RAILROAD MEDICARE
01
261210236
COMMERCIAL
01
3125128
COMMERCIAL
AL
05
529901280
AL
01
5567071
COMMERCIAL
AL
Enumeration date
01/11/2007
Last updated
04/13/2022
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