Provider Demographics
NPI:1285209106
Name:SEYMOUR, ASHLEY ELIZABETH (OD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:SEYMOUR
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 1:4313 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4777
Mailing Address - Country:US
Mailing Address - Phone:352-373-4300
Mailing Address - Fax:352-373-4572
Practice Address - Street 1:4313 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4777
Practice Address - Country:US
Practice Address - Phone:352-373-4300
Practice Address - Fax:352-373-4572
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6051152W00000X
PAOEG003794152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist