Pennell, Craig S
Pennell, Craig S is an sole proprietor health care provider with primary practice located at 1824 Declaration Dr , Independence KY 41051-8432. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Pennell, Craig S can be contacted via phone (859) 363-3347.Contact Information
Primary practice address
1824 Declaration Dr
Independence KY 41051-8432
Phone: (859) 363-3347
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 1168DT | Kentucky |
Profile Details
NPI number | 1841351228 |
---|---|
LBN Legal business name | Pennell, Craig S |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 12th, 2006 |
Last updated | Oct 14th, 2013 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841351228 | NPPES |
Kentucky | Other | 0966101 | MEDICARE ID |
Kentucky | MEDICAID | 77011682 | MEDICARE ID |
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