Provider Demographics
NPI:1437137890
Name:SEESE, HOBART J (OD)
Entity type:Individual
Prefix:
First Name:HOBART
Middle Name:J
Last Name:SEESE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 NELSON DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4275
Mailing Address - Country:US
Mailing Address - Phone:304-291-5565
Mailing Address - Fax:
Practice Address - Street 1:6051 UNIVERSITY TOWN CENTRE DR
Practice Address - Street 2:WAL-MART BLDG.
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-2292
Practice Address - Country:US
Practice Address - Phone:304-599-7337
Practice Address - Fax:866-465-6057
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV928OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0149798000Medicaid
WV4109271Medicare PIN
WV0149798000Medicaid