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
Fax: (270) 683-2507
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1336108927 NPPES
Kentucky MEDICAID 77000297

Popular Providers