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Contact Information

DARYL G. CUSTRED, O.D., L.L.C.
1499 N AIRPORT RD
JASPER, AL35504-8882
 Phone: 205-221-3721
 Fax: 205-221-2748
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for DARYL G. CUSTRED, O.D., L.L.C.

NPI Number 1891972352
LBN Legal business name DARYL G. CUSTRED, O.D., L.L.C.
Authorized official DARYL CUSTRED - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/28/2008
Last updated 11/14/2010 - About 16 years ago
Identifiers
AL License # S-505-TA-126
AL Other 103021 ALABAMA MEDICAID
AL Other DN9352 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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