=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669485108
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CURTIS M. NOBLE O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11610 MEMORIAL PKWY SW
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35803-2152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-881-3763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2608 GREEN MOUNTAIN RD SE
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35803-1934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-880-9778
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | S-475-TA-068
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------