Healthcare Provider Details

I. General information

NPI: 1730142167
Provider Name (Legal Business Name): JOSEPH ANTHONY SCHNORBUS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 COOSA STREET EAST SUITE A
TALLADEGA AL
35160-2546
US

IV. Provider business mailing address

109 COOSA STREET EAST SUITE A
TALLADEGA AL
35160-2546
US

V. Phone/Fax

Practice location:
  • Phone: 256-362-4872
  • Fax:
Mailing address:
  • Phone: 256-362-4872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-833-TA-381
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: