Brelage, Thomas G.

Brelage, Thomas G. is an sole proprietor health care provider with primary practice located at 206 W John Fitch Ave , Bardstown KY 40004-1115. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brelage, Thomas G. can be contacted via phone (502) 348-1107.

Contact Information

Primary practice address
206 W John Fitch Ave Bardstown KY 40004-1115
Phone: (502) 348-1107
Fax: (502) 348-0294
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 934DT Kentucky

Profile Details

NPI number 1083635676
LBN Legal business name Brelage, Thomas G.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2006
Last updated Nov 21st, 2013 - about 13 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 1083635676 NPPES
Kentucky MEDICAID 77009348
Kentucky Other 911185
Kentucky Other 1103277
Kentucky Other 000000050702

Popular Providers