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Individual

DR. STUART M GREENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
523 GANDY ST NE, SUITE A, RUSSELLVILLE, AL 35653-1961
(205) 208-9955
(888) 561-0756
Mailing address
PO BOX 1132, RUSSELLVILLE, AL 35653-1132
(205) 208-9955
(888) 561-0756

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
791
MS
152W00000X
Optometrist
OD0000002785
TN
152W00000X
Optometrist
OPT002359
GA
152W00000X
Optometrist
Primary
R148TA685
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009941838
AL
05
009980355
AL
05
05027897
MS
01
051006214
BCBS OF AL
AL
01
051526031
BCBS OF AL
AL
01
051527186
BCBS OF AL
AL
01
051527187
BCBS OF AL
AL
05
1510933
TN
05
781875998C
GA
Enumeration date
10/19/2006
Last updated
03/14/2014
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