Organization
JAMES WYNN JACOBS,M.D.
Active
Parent organization
J.WYNN JACOBS,M.D.
Other names
The Optical Shop
Organization subpart
Yes
Provider details
NPI number
Legal business name
J.WYNN JACOBS,M.D.
Authorized official
DR. JAMES WYNN JACOBS M.D. (PROPRIETOR)
(256) 582-1211
Entity
Organization
Contact information
Practice address
1436 GUNTER AVE, GUNTERSVILLE, AL 35976-1846
(256) 582-1211
(256) 582-2522
Mailing address
1436 GUNTER AVE, P.O.BOX 938, GUNTERSVILLE, AL 35976-1846
(256) 582-1211
(256) 582-2522
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
13234
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000017960
—
AL
Enumeration date
02/05/2008
Last updated
10/06/2008
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