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General NPI Number Information
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NPI Number | 1750679213
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Entity Type | Organization
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Legal Business Name | HARTLEY NICHOLS EYE CARE, LLC
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 518 SHERWOOD DR
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City | AUBURN
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State | AL
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Zip | 36830-6035
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Country | US
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Telephone | 205-910-5234
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Fax |
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Provider Business Mailing Address
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Address Line | 607 RENAISSANCE DR
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City | HOOVER
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State | AL
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Zip | 35226-4142
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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 | MEMBER/ORGANIZER
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Name | HARTLEY NICHOLS
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Credential | O.D.
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Telephone | 205-910-5234
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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-C43-TA-859
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License Number State | AL
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