Provider Demographics
NPI:1730287996
Name:SEBORAH W. KING, O.D. & ASSOCIATES, L.L.C.
Entity Type:Organization
Organization Name:SEBORAH W. KING, O.D. & ASSOCIATES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEBORAH
Authorized Official - Middle Name:W
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:478-737-6285
Mailing Address - Street 1:1005 UNDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-3332
Mailing Address - Country:US
Mailing Address - Phone:478-737-6286
Mailing Address - Fax:478-477-9149
Practice Address - Street 1:5955 ZEBULON RD
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2030
Practice Address - Country:US
Practice Address - Phone:478-471-9011
Practice Address - Fax:478-471-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001942152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty