Puckett, Randall K
Puckett, Randall K is an sole proprietor health care provider with primary practice located at 225 Hospital Dr Bldg B Ste 160 , Winchester KY 40391. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Puckett, Randall K can be contacted via phone (859) 744-4429.Contact Information
Primary practice address
225 Hospital Dr Bldg B Ste 160
Winchester KY 40391
Phone: (859) 744-4429
Fax: (859) 745-7702
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1190DT | Kentucky |
Profile Details
| NPI number | 1326031527 |
|---|---|
| LBN Legal business name | Puckett, Randall K |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1326031527 | NPPES |
| Kentucky | MEDICAID | 77011906 |
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