Provider Demographics
NPI:1871568246
Name:JAMES, MATTHEW S (OD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:S
Last Name:JAMES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-6102
Mailing Address - Country:US
Mailing Address - Phone:205-661-2080
Mailing Address - Fax:205-661-2085
Practice Address - Street 1:2737 HIGHWAY 280 S
Practice Address - Street 2:SUITE 191
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2466
Practice Address - Country:US
Practice Address - Phone:205-802-2020
Practice Address - Fax:205-803-0078
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-A52-TA-649152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009997065Medicaid
ALS-A52-TA-649OtherAL BOARD OF OPTOMETRY
ALS-A52-TA-649OtherAL BOARD OF OPTOMETRY
ALMJ1061643OtherDEA
ALS-A52-TA-649OtherAL BOARD OF OPTOMETRY