Healthcare Provider Details

I. General information

NPI: 1336702976
Provider Name (Legal Business Name): CARLTHAN LING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 UNIVERSITY BLVD STE 305
BIRMINGHAM AL
35233-1816
US

IV. Provider business mailing address

1720 UNIVERSITY BLVD STE 305
BIRMINGHAM AL
35233-1816
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8100
  • Fax: 205-325-8547
Mailing address:
  • Phone: 205-325-8100
  • Fax: 205-325-8547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number67882
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number47931
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: