Individual
DR. RONALD D. MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
832 PRINCETON AVE SW, BIRMINGHAM, AL 35211-1320
(833) 733-8742
(205) 634-5640
Mailing address
PO BOX 59449, BIRMINGHAM, AL 35259-9449
(833) 733-8742
(205) 634-5640
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-587-TA-195
AL
152W00000X
Optometrist
Primary
S587TA195
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00002584
—
AL
01
—
2210512
UNITED HEALTHCARE
AL
01
—
25842
BLUE CROSS
AL
01
—
3534
SENIORS FIRST
AL
01
—
990003808
MEDICARE RAILROAD
AL
01
—
T87426
VIVA HEALTHCARE
AL
Enumeration date
09/28/2006
Last updated
04/15/2026
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