Provider Demographics
NPI:1245699842
Name:DR. JO ANN GRAFFEO-KING, O.D.
Entity type:Organization
Organization Name:DR. JO ANN GRAFFEO-KING, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:REICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-666-6026
Mailing Address - Street 1:5256 HIGHWAY 90 W STE B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-4218
Mailing Address - Country:US
Mailing Address - Phone:251-666-6026
Mailing Address - Fax:251-666-6026
Practice Address - Street 1:5256 HIGHWAY 90 W STE B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-4218
Practice Address - Country:US
Practice Address - Phone:251-666-6026
Practice Address - Fax:251-666-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-534-TA-272152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1740387158OtherNPI
AL1740387158OtherNPI