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General NPI Number Information
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NPI Number | 1013281104
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Entity Type | Organization
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Legal Business Name | TYLER M. AMOS O.D., P.C.
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 184 OLD HIGHWAY 431 SUITE C
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City | OWENS CROSS ROADS
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State | AL
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Zip | 35763-9281
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Country | US
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Telephone | 256-469-6073
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Fax | 256-469-6085
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Provider Business Mailing Address
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Address Line | 184 OLD HIGHWAY 431 SUITE C
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City | OWENS CROSS ROADS
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State | AL
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Zip | 35763-9281
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Country | US
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Telephone | 256-469-6073
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Fax | 256-469-6085
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Authorized Official
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Title or Position | OPTOMETRIST/ OWNER
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Name | DR. TYLER MARK AMOS
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Credential | O.D.
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Telephone | 256-469-6073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S999TA565
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License Number State | AL
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