1073666343 NPI number — MRS. LINDA HATCHER OPTHALMIC DISPENSER

Table of content: MRS. LINDA HATCHER OPTHALMIC DISPENSER (NPI 1073666343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073666343 NPI number — MRS. LINDA HATCHER OPTHALMIC DISPENSER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HATCHER
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OPTHALMIC DISPENSER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073666343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
246 POPLAR AVE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
SOMERSET
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42503-1701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-679-8469
Provider Business Mailing Address Fax Number:
606-678-8891

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
246 POPLAR AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42503-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-679-8469
Provider Business Practice Location Address Fax Number:
606-678-8891
Provider Enumeration Date:
01/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  498 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 180021 0118 . This is a "NVA PROVIDER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 52800950 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 52904984 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 33451 . This is a "AVESIS PROVIDER ID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 246909 . This is a "CLARITY PROVIDER ID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 10199 . This is a "SPECTERA INSURANCE PROVID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50525 . This is a "DAVIS VISION PROVIDER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000340307 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1176629 . This is a "CHA HEALTH PROVIDER NUMBE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: OP1414 . This is a "EYEMED PROVIDER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com