MEDICARE: DR. DAVID RUFUS FLOYD OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	S297	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51059917	OTHER	AL	BC BS

General Provider Information

NPI Number	:	1457421240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RUFUS FLOYD OD

Provider Business Mailing Address
First Line	:	DR DAVID FLOYD 1737 W 3RD STREET
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-1505
Country	:	US
Telephone Number	:	334-264-6917
Fax Number	:

Provider Business Practice Location Address
First Line	:	1737 W 3RD STREET
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-1505
Country	:	US
Telephone Number	:	334-264-6917
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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