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General NPI Number Information
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NPI Number | 1710918289
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Entity Type | Organization
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Legal Business Name | SPUTH CENTER FOR SIGHT, LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 1030 FAIRFAX PARK
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2806
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Country | US
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Telephone | 205-752-1584
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Fax | 205-752-9987
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Provider Business Mailing Address
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Address Line | 1030 FAIRFAX PARK
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2806
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Country | US
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Telephone | 205-752-1584
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Fax | 205-752-9987
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC B. SPUTH
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Credential | MD
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Telephone | 205-752-1584
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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 | 00027460
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License Number State | AL
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