| Name: | Whatley Eye Care, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 08 Dec 2005 (19 years ago) |
| Entity Number: | 000-244-587 |
| Register Number: | 000244587 |
| County: | Lee |
| Place of Formation: | Lee County |
| Registered Office Street Address: | 518 AVENUE AOPELIKA, AL 36801 |
| Registered Office Street Address ZIP Code: | 36801 |
| Principal Address: | OPELIKA, AL |
| Authorized Capital: | $1,000 |
Activities
OPTOMETRY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538237771 | 2006-12-04 | 2015-11-10 | 518 AVENUE A, OPELIKA, AL, 368015064, US | 518 AVENUE A, OPELIKA, AL, 368015064, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 334-745-3112 |
| Fax | 3347458751 |
Authorized person
| Name | DR. RUSSELL LEE WHATLEY |
| Role | PRESIDENT |
| Phone | 3347453112 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S-720-TA-192 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 51531835 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529926430 |
| State | AL |
| Issuer | UNITED HEALTH CARE |
| Number | OT42627 |
| State | AL |
| Name | Role |
|---|---|
| WHATLEY, RUSSELL L | Agent |
| Name | Role |
|---|---|
| WHATLEY, RUSSELL L | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
