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General NPI Number Information
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NPI Number | 1326389768
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Entity Type | Organization
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Legal Business Name | DAVID OLIVE, OD, PC
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Dates
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Enumeration Date | 03/11/2013
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 1717 S COLLEGE ST
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City | AUBURN
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State | AL
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Zip | 36832-5870
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Country | US
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Telephone | 334-663-2568
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Fax |
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Provider Business Mailing Address
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Address Line | 3040 HAMILTON RD
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City | AUBURN
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State | AL
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Zip | 36830-7556
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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 | PRESIDENT
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Name | DAVID OLIVE
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Credential | O.D.
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Telephone | 334-663-2568
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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-931-TA-494
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License Number State | AL
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