Provider Demographics
NPI:1649470444
Name:HUNTSVILLE CENTER FOR SIGHT
Entity type:Organization
Organization Name:HUNTSVILLE CENTER FOR SIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:K
Authorized Official - Last Name:THORSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-536-7483
Mailing Address - Street 1:2780 BOB WALLACE AVE SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-4104
Mailing Address - Country:US
Mailing Address - Phone:256-536-7483
Mailing Address - Fax:256-536-7586
Practice Address - Street 1:2780 BOB WALLACE AVE SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-4104
Practice Address - Country:US
Practice Address - Phone:256-536-7483
Practice Address - Fax:256-536-7586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9761207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1215997143OtherNPI FOR DR CRAIG THORSTA
AL316906969OtherNPI FOR DR WALTER HUBICKE
AL1215997143OtherNPI FOR DR CRAIG THORSTA
ALF99683Medicare UPIN
AL6038900001Medicare NSC