Basic Information
| Provider Information | |||||||||
| NPI: | 1548518319 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAGANI | ||||||||
| FirstName: | SUNITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 WHITESBURG DR SE STE 103 | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358021677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2568082000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7880 OLD MADISON PIKE | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567728711 | ||||||||
| FaxNumber: | 2567728738 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2012 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | S-C83-TA-930 | AL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.