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General NPI Number Information
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NPI Number | 1174882013
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Entity Type | Organization
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Legal Business Name | WORTHINGTON OPHTHALMOLOGY INC
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Dates
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Enumeration Date | 05/13/2012
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Last Update Date | 05/13/2012
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Provider Practice Location Address
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Address Line | 89 E WILSON BRIDGE RD
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City | WORTHINGTON
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State | OH
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Zip | 43085-6315
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Country | US
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Telephone | 614-598-9047
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Fax |
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Provider Business Mailing Address
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Address Line | 89 E WILSON BRIDGE RD
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City | WORTHINGTON
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State | OH
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Zip | 43085-6315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TRENT DAVIS ALBRIGHT
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Credential | M.D.
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Telephone | 614-598-9047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35.097049
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License Number State | OH
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