Provider Demographics
NPI:1063495265
Name:DUVAL, DAVID P (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:DUVAL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 COTTAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-4216
Mailing Address - Country:US
Mailing Address - Phone:215-666-5060
Mailing Address - Fax:215-666-5060
Practice Address - Street 1:4219 COTTAGE HILL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4216
Practice Address - Country:US
Practice Address - Phone:215-666-5060
Practice Address - Fax:215-666-5060
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS338TA250152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL39864Medicare ID - Type Unspecified
T69191Medicare UPIN
AL39864Medicare PIN
AL1074080010Medicare NSC