Tade, Darrell L

Tade, Darrell L is an individual health care provider with primary practice located at 760 Campbell Ln Ste 120 , Bowling Green KY 42104-1085. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Tade, Darrell L can be contacted via phone (270) 781-3937.

Contact Information

Primary practice address
760 Campbell Ln Ste 120 Bowling Green KY 42104-1085
Fax: (270) 783-3435
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1142DT Kentucky

Profile Details

NPI number 1871645614
LBN Legal business name Tade, Darrell L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Feb 3rd, 2014 - about 12 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 1871645614 NPPES
Kentucky MEDICAID 77011427

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