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General NPI Number Information
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NPI Number | 1710138060
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Entity Type | Organization
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Legal Business Name | JO ANN G. KING,O.D. & ASSOCIATES
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 5245 RANGELINE SERVICE RD S
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City | MOBILE
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State | AL
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Zip | 36619-9541
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Country | US
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Telephone | 251-666-3070
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Fax | 251-661-9022
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Provider Business Mailing Address
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Address Line | 5245 RANGELINE SERVICE RD S
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City | MOBILE
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State | AL
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Zip | 36619-9541
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Country | US
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Telephone | 251-666-3070
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Fax | 251-661-9022
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. JO ANN G KING
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Credential | O.D.
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Telephone | 251-666-3070
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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 | S534TA272
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License Number State | AL
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