Provider Demographics
NPI:1942630629
Name:AUGUSTA PLASSMANN KING, O.D., LLC
Entity Type:Organization
Organization Name:AUGUSTA PLASSMANN KING, O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTA
Authorized Official - Middle Name:PLASSMANN
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:719-641-7431
Mailing Address - Street 1:2861 BEVERLY LANE
Mailing Address - Street 2:UNIT B
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-6024
Mailing Address - Country:US
Mailing Address - Phone:719-641-7431
Mailing Address - Fax:
Practice Address - Street 1:1521 STACIA ST
Practice Address - Street 2:GOLDEN NORTH OPTICS
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-456-4822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK346152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty