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General NPI Number Information
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NPI Number | 1649427543
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Entity Type | Organization
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Legal Business Name | SEVIGNY & ASSOCIATES EYE CARE, PA
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 735 N 6TH AVE
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City | WAUCHULA
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State | FL
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Zip | 33873-2002
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Country | US
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Telephone | 863-773-3322
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Fax | 863-773-6458
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Provider Business Mailing Address
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Address Line | 735 N 6TH AVE
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City | WAUCHULA
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State | FL
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Zip | 33873-2002
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Country | US
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Telephone | 863-773-3322
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Fax | 863-773-6458
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. MARK D. SEVIGNY
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Credential | O.D.
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Telephone | 863-773-3322
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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 | 152W00000X
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License Number State | FL
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