Healthcare Provider Details
I. General information
NPI: 1114966090
Provider Name (Legal Business Name): ALTOONA OPHTHALMOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2006
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
- Phone: 814-946-0821
- Fax: 814-941-2520
- Phone: 814-946-0821
- Fax: 814-941-2520
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
M
BUDD
Title or Position: PRESIDENT
Credential: MD
Phone: 814-946-0821