Organization
OPTICAL DIMENSIONS
Active
Other names
Phoenix Optical
Organization subpart
No
Provider details
NPI number
Authorized official
GINA EVANS LEACHMAN (OFFICE MANAGER)
(251) 473-4003
Entity
Organization
Contact information
Practice address
6750 AIRPORT BLVD STE A, MOBILE, AL 36608-3792
(251) 342-1223
(251) 342-2495
Mailing address
6750 AIRPORT BLVD STE A, MOBILE, AL 36608-3792
(251) 342-1223
(251) 342-2495
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I615
MEDICARE FOR OD
AL
01
—
I617
MEDICARE FOR PO
AL
Enumeration date
10/12/2006
Last updated
12/18/2007
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