Traylor, Marty Shane
Traylor, Marty Shane is an individual health care provider with primary practice located at 3310 Professional Park Suite 101, Owensboro KY 42303-4551. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Traylor, Marty Shane can be contacted via phone (270) 683-2101.Contact Information
Primary practice address
3310 Professional Park Suite 101
Owensboro KY 42303-4551
Phone: (270) 683-2101
Fax: (270) 683-2507
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1492DT | Kentucky |
Profile Details
| NPI number | 1336108927 |
|---|---|
| LBN Legal business name | Traylor, Marty Shane |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jul 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336108927 | NPPES |
| Kentucky | MEDICAID | 77000297 |
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