Mayes, Freddie Michael

Mayes, Freddie Michael is an sole proprietor health care provider with primary practice located at 1601 West Everly Brothers Blvd , Central City KY 42330-0676. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mayes, Freddie Michael can be contacted via phone (270) 754-4515.

Contact Information

Primary practice address
1601 West Everly Brothers Blvd Central City KY 42330-0676
Phone: (270) 754-4515
Fax: (270) 754-2547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 906DT Kentucky

Profile Details

NPI number 1548251333
LBN Legal business name Mayes, Freddie Michael
Credentials OD OPTOMETRIST
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2005
Last updated Jun 18th, 2013 - about 11 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 1548251333 NPPES
Kentucky Other 000000319883 ANTHEM BLUE CROSS
Kentucky Other KY0906 ANTHEM BLUE CROSS
Kentucky MEDICAID 77009066 ANTHEM BLUE CROSS

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