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General NPI Number Information
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NPI Number | 1164434536
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Entity Type | Organization
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Legal Business Name | DRS. COULTER, MCROY & ASSOCIATES PC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 8200 WHITESBURG DRIVE SOUTH
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City | HUNTSVILLE
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State | AL
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Zip | 35802
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Country | US
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Telephone | 256-880-8058
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Fax | 256-880-1277
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Provider Business Mailing Address
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Address Line | 8200 WHITESBURG DRIVE SOUTH
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City | HUNTSVILLE
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State | AL
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Zip | 35802
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Country | US
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Telephone | 256-880-8058
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Fax | 256-880-1277
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Authorized Official
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Title or Position | OFFICE COMPTROLLER
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Name | MONA MCROY VINES
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Credential | CPO
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Telephone | 256-880-8058
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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 | S-595-TA-298
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | R151TA719
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S595 TA 298
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-847-TA-353
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License Number State | AL
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