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General NPI Number Information
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NPI Number | 1386787299
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Entity Type | Individual
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Provider Name | MARY ELIZABETH SEZER O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 1120 15TH ST
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City | AUGUSTA
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State | GA
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Zip | 30912-2566
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Country | US
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Telephone | 706-721-1148
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Fax |
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Provider Business Mailing Address
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Address Line | 4643 HUNTERS MILL CT
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City | HEPHZIBAH
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State | GA
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Zip | 30815-2029
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Country | US
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Telephone | 443-876-3680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2240
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003308
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License Number State | GA
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