Dr. Lorraine Deangelis Summerlin, O. D.
Optometrist in Grant, AL. Individual provider (NPI-1).
NPI number1720161425
StatusActive
Last updated in NPPESApr 8, 2009
Details
- NPI
- 1720161425
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lorraine Deangelis Summerlin
- Credential
- O. D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2006
- Last updated
- Apr 8, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | s969ta526 | AL | Yes |
| 152W00000X | Optometrist | opt001876 | GA | |
| 152W00000X | Optometrist | od0000002212 | TN |
Practice location
5447 Main StGrant, AL 35747-8322
Phone 256-728-3937 · Fax 256-728-3938
Mailing address
5447 Main StGrant, AL 35747-8322
Phone 256-728-3937
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