Avery, Dwight L

Avery, Dwight L is an individual health care provider with primary practice located at 941 N Main Street , Hazard KY 41701. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Avery, Dwight L can be contacted via phone (606) 439-4010.

Contact Information

Primary practice address
941 N Main Street Hazard KY 41701
Fax: (606) 439-0880
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1120OT Kentucky

Profile Details

NPI number 1992883243
LBN Legal business name Avery, Dwight L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Nov 6th, 2012 - about 14 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 1992883243 NPPES
Kentucky MEDICAID 77011203

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