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NPI 1841523909

NPI 1841523909 : DR.PAUL W.SECK,O.D.P.C. : HAMPTON, VA

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General NPI Number Information
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    NPI Number           |    1841523909
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    Entity Type          |    Organization 
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    Legal Business Name  |    DR.PAUL W.SECK,O.D.P.C. 
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Dates
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    Enumeration Date     |    09/08/2009
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    Last Update Date     |    09/08/2009
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Provider Practice Location Address
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    Address Line         |    2115 EXECUTIVE DR 
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    City                 |    HAMPTON
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    State                |    VA
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    Zip                  |    23666-2499
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    Country              |    US
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    Telephone            |    757-826-5800
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    Fax                  |    757-826-5800
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Provider Business Mailing Address
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    Address Line         |    2115 EXECUTIVE DR 
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    City                 |    HAMPTON
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    State                |    VA
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    Zip                  |    23666-2499
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    Country              |    US
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    Telephone            |    757-826-5800
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    Fax                  |    757-826-5800
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. PAUL W SECK 
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    Credential           |    O.D.
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    Telephone            |    757-826-5800
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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       |    0618000516
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    License Number State |    VA
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