Individual
STEVEN R LANDRETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3519 WATERMELON RD, NORTHPORT, AL 35473-5174
(205) 758-0242
Mailing address
1655 MCFARLAND BLVD N, SUITE 127, TUSCALOOSA, AL 35406-2212
(205) 758-0242
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S914TA467
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051554102
—
AL
01
—
51500676
BCBS OF AL
AL
Enumeration date
05/10/2007
Last updated
01/13/2011
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