Provider Demographics
NPI:1982329595
Name:ALEX HUTZELL, O.D.,P.C.
Entity Type:Organization
Organization Name:ALEX HUTZELL, O.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTZELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:707-218-8127
Mailing Address - Street 1:2424 SHASTA WAY
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-4354
Mailing Address - Country:US
Mailing Address - Phone:541-882-2812
Mailing Address - Fax:541-882-5075
Practice Address - Street 1:2424 SHASTA WAY
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-4354
Practice Address - Country:US
Practice Address - Phone:541-882-2812
Practice Address - Fax:541-882-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty