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DR. DANNY LARUE HARTZOG O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1669555033

Individual Registrant:
DR. DANNY LARUE HARTZOG O.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
6 W COLLEGE ST  CLAYTON, AL 36016-5106 US
Tel: 334-775-3295  Fax: 334-775-8269

Contact information for business:
PO BOX 519  CLAYTON, AL 36016-0519 US
Tel: 334-775-3295  Fax: 334-775-8269

Registration Information:
NPI: 1669555033
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
ALS377TA045

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBS51059440AL01
59440AL05




HEALTH CARE JOBS AL - Page 1



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