Provider Demographics
NPI:1487978813
Name:SMALL, SARAH MARTIN (OD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARTIN
Last Name:SMALL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SPRING HILL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1416
Mailing Address - Country:US
Mailing Address - Phone:251-633-4949
Mailing Address - Fax:251-341-2903
Practice Address - Street 1:831 HILLCREST RD STE C
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4075
Practice Address - Country:US
Practice Address - Phone:251-633-4949
Practice Address - Fax:251-341-2903
Is Sole Proprietor?:No
Enumeration Date:2010-03-13
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS815152W00000X
ALS-C47-TA-857152W00000X
TN2917152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1063439065OtherNPI GROUP SITE PAYEE NUMBER
AL011846OtherMEDICARE GROUP NUMBER
AL630000013Medicaid