Provider Demographics
NPI:1003385600
Name:DR. JAMES KOMORNIK LLC
Entity Type:Organization
Organization Name:DR. JAMES KOMORNIK LLC
Other - Org Name:SEA EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:KOMORNIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-644-7234
Mailing Address - Street 1:9573 SHORE DR STE E
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-1722
Mailing Address - Country:US
Mailing Address - Phone:757-644-7234
Mailing Address - Fax:757-296-0839
Practice Address - Street 1:9573 SHORE DR STE E
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-1722
Practice Address - Country:US
Practice Address - Phone:757-644-7234
Practice Address - Fax:757-296-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty