Healthcare Provider Details

I. General information

NPI: 1821481367
Provider Name (Legal Business Name): THOMAS HUFNAL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WEST 10TH STREET- SUITE 115
WILMINGTON DE
19899
US

IV. Provider business mailing address

326 GARRISON CIRCLE
SMYRNA DE
19977
US

V. Phone/Fax

Practice location:
  • Phone: 302-563-4740
  • Fax:
Mailing address:
  • Phone: 302-538-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberI30001131
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: