Gossom, Donald J

Gossom, Donald J is an individual health care provider with primary practice located at 7635 Shelbyville Rd , Louisville KY 40222-5409. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Gossom, Donald J can be contacted via phone (502) 423-8500.

Contact Information

Primary practice address
7635 Shelbyville Rd Louisville KY 40222-5409
Phone: (502) 423-8500
Fax: (502) 339-0571
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 1364DT Kentucky

Profile Details

NPI number 1457325896
LBN Legal business name Gossom, Donald J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Jan 21st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457325896 NPPES
Kentucky MEDICAID 77013647
Kentucky Other 000000047535
Kentucky Other 5420222

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