Healthcare Provider Details

I. General information

NPI: 1659314680
Provider Name (Legal Business Name): ALTOONA OPHTHALMOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E PLEASANT VALLEY BLVD
ALTOONA PA
16602-5530
US

IV. Provider business mailing address

600 E PLEASANT VALLEY BLVD
ALTOONA PA
16602-5530
US

V. Phone/Fax

Practice location:
  • Phone: 814-946-0821
  • Fax: 814-941-2520
Mailing address:
  • Phone: 814-946-0821
  • Fax: 814-941-2520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M BUDD
Title or Position: PRESIDENT
Credential: MD
Phone: 814-946-0821