MEDICARE: DR. HOWARD RUSSELL DAY JR. MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207W00000X	Ophthalmology Physician	48287	AL

General Provider Information

NPI Number	:	1639799513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD RUSSELL DAY JR. MD

Provider Business Mailing Address
First Line	:	3555 KINGSHILL RD
Second Line	:
City	:	MOUNTAIN BRK
State	:	AL
Zip	:	35223-1421
Country	:	US
Telephone Number	:	205-441-8864
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 PIERCE AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0025
Country	:	US
Telephone Number	:	615-936-2020
Fax Number	:

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

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	05/22/2024

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