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Individual

DR. PAUL F. VANDIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4929 UNIVERSITY DR NW, SUITE F, HUNTSVILLE, AL 35816-1862
(256) 964-2020
(256) 830-5239
Mailing address
PO BOX 1310, TRUSSVILLE, AL 35173-6102
(205) 661-2080
(205) 661-2085

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-A86-TA-680
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009932978
AL
05
051528869
AL
05
116545
AL
01
S-A86-TA-680
AL BOARD OF OPTOMETRY
AL
Enumeration date
02/22/2006
Last updated
03/07/2023
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