Basic Information
| Provider Information | |||||||||
| NPI: | 1083882161 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR RICHARD DRAYER, OPTOMETRIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 149 FRANKFORT ST | ||||||||
| Address2: | |||||||||
| City: | VERSAILLES | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403831121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598737805 | ||||||||
| FaxNumber: | 8598739653 | ||||||||
| Practice Location | |||||||||
| Address1: | 149 FRANKFORT ST | ||||||||
| Address2: | |||||||||
| City: | VERSAILLES | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403831121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598737805 | ||||||||
| FaxNumber: | 8598739653 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2008 | ||||||||
| LastUpdateDate: | 02/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | EVERETT | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | INSURANCE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8598737805 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 918DT | KY | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.