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Organization

CHEROKEE EYE CLINIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MYRON WILSON O.D. (OWNER)
(256) 927-4030
Entity
Organization

Contact information

Practice address
280 W MAIN ST, CENTRE, AL 35960-1326
(256) 927-4030
(256) 927-2586
Mailing address
280 W MAIN ST, CENTRE, AL 35960-1326
(256) 927-4030
(256) 927-2586

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-542-TA-135
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000059743
AL
01
51059743
BLUE CROSS/BLUE SHIELD
AL
01
5947260
AETNA
AL
Enumeration date
08/31/2006
Last updated
06/08/2010
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