NPIMap

Organization Active NPI

Huntsville Laser Center, LLC

  • Ophthalmology Physician
  • Huntsville, AL
National Provider Identifier
1043424203
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
21789 Issued in AL
Legal business name
HUNTSVILLE LASER CENTER, LLC
Practice address
120 Governors Dr SE
Suite 101
Huntsville, AL 35801-4320
Phone
(256) 704-3937
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William N Mitchell, M.D.
Title
Owner
Phone
(256) 704-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 21789 AL Primary

Addresses

Primary practice location

120 Governors Dr SE
Suite 101
Huntsville, AL 35801-4320

Mailing address

120 Governors Drive SE
Suite 101
Huntsville, AL 35801
Phone (256) 704-3937

Other identifiers 1

IdentifierTypeStateIssuer
51008937OtherALBCBS

National Provider Directory

National Provider Directory

Locations

120 Governors Dr SE
Ste 101
Huntsville, AL 35801
Phone (256) 704-3937

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043424203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GOVERNORS DRIVE SE",
            "address_2": "SUITE 101",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-704-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GOVERNORS DR SE",
            "address_2": "SUITE 101",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014320",
            "telephone_number": "256-704-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSVILLE LASER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-704-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "21789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51008937",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.