Organization
RETINA SPECIALISTS OF WEST ALABAMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WAYNE TAYLOR JR. M.D. (MEMBER)
(205) 343-0003
Entity
Organization
Contact information
Practice address
500 HARGROVE RD E, TUSCALOOSA, AL 35401-3751
(205) 343-0003
(205) 343-0029
Mailing address
2101 HIGHLAND AVE S STE 350, BIRMINGHAM, AL 35205-4009
(205) 558-2525
(205) 558-2554
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529931100
—
AL
Enumeration date
09/28/2006
Last updated
05/19/2020
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