Healthcare Provider Details

I. General information

NPI: 1316901028
Provider Name (Legal Business Name): HORACE W. LINDER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17154 AL HWY 75
HENAGAR AL
35978
US

IV. Provider business mailing address

P.O. BOX 236
HENAGAR AL
35978
US

V. Phone/Fax

Practice location:
  • Phone: 256-657-3453
  • Fax: 256-657-3294
Mailing address:
  • Phone: 256-657-3453
  • Fax: 256-657-3294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS323TA332
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: