Healthcare Provider Details

I. General information

NPI: 1932136355
Provider Name (Legal Business Name): EDGAR LOWNDES READY IV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MERIDIAN ST N SUITE 400
HUNTSVILLE AL
35801-4720
US

IV. Provider business mailing address

401 MERIDIAN ST N SUITE 400
HUNTSVILLE AL
35801-4720
US

V. Phone/Fax

Practice location:
  • Phone: 256-539-8851
  • Fax: 256-534-7203
Mailing address:
  • Phone: 256-539-8851
  • Fax: 256-534-7203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number24301
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number24301
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: