Healthcare Provider Details
I. General information
NPI: 1275850885
Provider Name (Legal Business Name): PETER ZLOTY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3290 DAUPHIN ST SUITE 401
MOBILE AL
36606-4053
US
IV. Provider business mailing address
250 STATE FARM PKWY
BIRMINGHAM AL
35209-7181
US
V. Phone/Fax
- Phone: 251-471-3309
- Fax: 251-471-5046
- Phone: 205-943-4650
- Fax: 205-943-4688
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PETER
ZLOTY
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 251-471-3309