Provider Demographics
NPI:1548518319
Name:JAGANI, SUNITA (OD)
Entity type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:
Last Name:JAGANI
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 1:4601 WHITESBURG DR SE STE 103
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1677
Mailing Address - Country:US
Mailing Address - Phone:256-808-2000
Mailing Address - Fax:
Practice Address - Street 1:7880 OLD MADISON PIKE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-772-8711
Practice Address - Fax:256-772-8738
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C83-TA-930152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist