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General NPI Number Information
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NPI Number | 1619298049
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Entity Type | Individual
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Provider Name | KRISTINA LOVINGGOOD O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 06/12/2012
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Provider Practice Location Address
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Address Line | 801 DALLAS AVE
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City | SELMA
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State | AL
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Zip | 36701-5454
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Country | US
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Telephone | 334-874-7024
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Fax | 334-874-7372
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Provider Business Mailing Address
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Address Line | 801 DALLAS AVE
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City | SELMA
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State | AL
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Zip | 36701-5454
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Country | US
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Telephone | 334-874-7024
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Fax | 334-874-7372
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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 | S-C32
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License Number State | AL
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