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General NPI Number Information
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NPI Number | 1437194867
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Entity Type | Organization
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Legal Business Name | RETINA SPECIALISTS OF ALABAMA LLC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 2208 UNIVERSITY BLVD STE 101
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2313
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Country | US
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Telephone | 205-933-2625
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Fax | 205-558-2567
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Provider Business Mailing Address
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Address Line | 2208 UNIVERSITY BLVD STE 101
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2313
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Country | US
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Telephone | 205-933-2625
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Fax | 205-558-2567
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATHEW R SAPP
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Credential | M.D.
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Telephone | 205-933-2625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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