Small, Heather Moon
Small, Heather Moon is an individual health care provider with primary practice located at 27453 Capshaw Rd Ste B , Athens AL 35613-7565. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Small, Heather Moon can be contacted via phone (256) 230-9637.Contact Information
Primary practice address
27453 Capshaw Rd Ste B
Athens AL 35613-7565
Phone: (256) 230-9637
Fax: (256) 230-0143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 631274146 | Alabama |
Profile Details
| NPI number | 1164736583 |
|---|---|
| LBN Legal business name | Small, Heather Moon |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2010 |
| Last updated | Oct 16th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164736583 | NPPES |
| Alabama | MEDICAID | 126155 |
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