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General NPI Number Information
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NPI Number | 1174588057
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Entity Type | Organization
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Legal Business Name | VALLEY EYE, PC
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 201 ROSA LN
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City | FLORENCE
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State | AL
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Zip | 35630-1770
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Country | US
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Telephone | 256-760-8484
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Fax | 256-760-7272
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Provider Business Mailing Address
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Address Line | PO BOX 430
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City | KILLEN
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State | AL
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Zip | 35645-0430
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Country | US
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Telephone | 256-760-8484
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Fax | 256-760-7272
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Authorized Official
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Title or Position | OWNER, OPTHALMOLOGIST
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Name | DR. GEORGE MICHAEL TAFT
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Credential | D.O.
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Telephone | 256-760-8484
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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 | SA55TA639
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License Number State | AL
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