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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1841351228 NPPES
Kentucky Other 0966101 MEDICARE ID
Kentucky MEDICAID 77011682 MEDICARE ID

Popular Providers