Organization
DR RONALD SEALOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD H SEALOCK OD (OWNER)
(334) 793-9607
Entity
Organization
Contact information
Practice address
1623 W MAIN ST, DOTHAN, AL 36301-1315
(334) 793-9607
Mailing address
1623 W MAIN ST, DOTHAN, AL 36301-1315
(334) 793-9607
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
S371TA081
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000059644
—
AL
Enumeration date
04/14/2008
Last updated
06/13/2008
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