Organization
DR. JEFFERY B. FORD AND ASSOC. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERY B FORD O.D. (PRESIDENT)
(334) 230-9694
Entity
Organization
Contact information
Practice address
1501 AL HIGHWAY 14 E, SELMA, AL 36703-3201
(334) 874-8357
Mailing address
1963 WALNUT ST, MONTGOMERY, AL 36106-1532
(334) 230-9694
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S 910 TA 465
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529929840
—
AL
Enumeration date
08/18/2008
Last updated
08/18/2008
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