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General NPI Number Information
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NPI Number | 1649470444
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Entity Type | Organization
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Legal Business Name | HUNTSVILLE CENTER FOR SIGHT
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 2780 BOB WALLACE AVE SW
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City | HUNTSVILLE
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State | AL
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Zip | 35805-4104
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Country | US
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Telephone | 256-536-7483
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Fax | 256-536-7586
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Provider Business Mailing Address
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Address Line | 2780 BOB WALLACE AVE SW
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City | HUNTSVILLE
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State | AL
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Zip | 35805-4104
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Country | US
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Telephone | 256-536-7483
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Fax | 256-536-7586
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Authorized Official
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Title or Position | MD OWNER
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Name | DR. CRAIG K THORSTAD
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Credential | MD
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Telephone | 256-536-7483
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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 | 9761
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License Number State | AL
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