Provider Demographics
NPI:1366458580
Name:PALMER, PATTI LU (OD)
Entity Type:Individual
Prefix:DR
First Name:PATTI
Middle Name:LU
Last Name:PALMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 EMORY DR
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-9618
Mailing Address - Country:US
Mailing Address - Phone:256-541-0614
Mailing Address - Fax:
Practice Address - Street 1:600 SAINT CLAIR AVE SW
Practice Address - Street 2:BLDG 6 SUITE 14
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5008
Practice Address - Country:US
Practice Address - Phone:256-536-4700
Practice Address - Fax:256-536-4117
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00458000152W00000X
ALR157TA743152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist