Fife, Sally M

Fife, Sally M is an sole proprietor health care provider with primary practice located at 300 9Th St , Henderson KY 42420-2751. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Fife, Sally M can be contacted via phone (270) 827-8681.

Contact Information

Primary practice address
300 9Th St Henderson KY 42420-2751
Fax: (270) 826-7687
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1017DT Kentucky

Profile Details

NPI number 1053470542
LBN Legal business name Fife, Sally M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2006
Last updated Aug 9th, 2011 - about 15 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 1053470542 NPPES
Kentucky MEDICAID 7100121660
Kentucky Other 0675230001
Kentucky Other 000000190215

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