| Name: | Dobbs Eye Clinic, P.A. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Association |
| Status: | Exists |
| Date of registration: | 27 Jun 1983 (41 years ago) |
| Entity Number: | 000-064-667 |
| Register Number: | 000064667 |
| County: | Coffee |
| Place of Formation: | Coffee County |
| Principal Address: | 207 S MAIN STREETENTERPRISE, AL 36330 |
| Principal Address ZIP Code: | 36330 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679690143 | 2007-03-22 | 2008-06-20 | PO BOX 311390, ENTERPRISE, AL, 363311390, US | 207 S MAIN ST, ENTERPRISE, AL, 363302544, US | |||||||||||||||||||||
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| Phone | +1 334-347-8900 |
| Fax | 3343471480 |
Authorized person
| Name | MS. KIMBERLY LYNN HUTCHINSON |
| Role | OFFICE MANAGER |
| Phone | 3343478900 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 528202440 |
| State | AL |
| Name | Role |
|---|---|
| DOBBS, GARY | Member |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
