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General NPI Number Information
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NPI Number | 1770616989
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Entity Type | Organization
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Legal Business Name | JOSHUA DRIVER PC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 604 N MAIN ST STE A
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City | OPP
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State | AL
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Zip | 36467-1600
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Country | US
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Telephone | 334-493-6600
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Fax | 334-493-2991
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Provider Business Mailing Address
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Address Line | 604 N MAIN ST STE A
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City | OPP
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State | AL
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Zip | 36467-1600
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Country | US
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Telephone | 334-493-6600
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Fax | 334-493-2991
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Authorized Official
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Title or Position | DOCTOR
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Name | JOSHUA DRIVER
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Credential | PC
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Telephone | 334-493-6600
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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 |
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License Number State |
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