Stallard, Kevin D

Stallard, Kevin D is an individual health care provider with primary practice located at 1303 Suite 108 Us 127 South , Frankfort KY 40601. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stallard, Kevin D can be contacted via phone (502) 875-3050.

Contact Information

Primary practice address
1303 Suite 108 Us 127 South Frankfort KY 40601
Phone: (502) 875-3050
Fax: (502) 226-4261
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1349DT Kentucky

Profile Details

NPI number 1770575805
LBN Legal business name Stallard, Kevin D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Feb 19th, 2014 - 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 1770575805 NPPES
Kentucky Other 1349DT OD LICENSE NUMBER
Kentucky MEDICAID 77013498 OD LICENSE NUMBER
Kentucky Other P00293402 OD LICENSE NUMBER
Kentucky Other 000000351950 OD LICENSE NUMBER

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