Individual
DR. KENNETH DELTON HARTZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
249 SOUTH 6TH STREET, GADSDEN, AL 35901-4102
(256) 546-4647
(256) 546-4272
Mailing address
249 SOUTH 6TH STREET, GADSDEN, AL 35901-4102
(256) 546-4647
(256) 546-4272
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT000791
GA
152W00000X
Optometrist
Primary
S357TA046
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000059427
—
AL
Enumeration date
10/31/2006
Last updated
12/19/2013
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