Provider Demographics
NPI:1326447822
Name:ANSLEY, TIMOTHY (OD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:ANSLEY
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 1:1809 DATA DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1238
Mailing Address - Country:US
Mailing Address - Phone:205-982-5000
Mailing Address - Fax:205-982-5920
Practice Address - Street 1:1809 DATA DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1238
Practice Address - Country:US
Practice Address - Phone:205-982-5000
Practice Address - Fax:205-982-5920
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSD17TA988152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427183342OtherGROUP NPI