MEDICARE: METZGER OPTOMETRY GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1205435591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METZGER OPTOMETRY GROUP, LLC

Provider Business Mailing Address
First Line	:	7517 ALEXANDRIA PIKE
Second Line	:
City	:	ALEXANDRIA
State	:	KY
Zip	:	41001-1041
Country	:	US
Telephone Number	:	859-635-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	7517 ALEXANDRIA PIKE
Second Line	:
City	:	ALEXANDRIA
State	:	KY
Zip	:	41001-1041
Country	:	US
Telephone Number	:	859-635-7600
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. WILLIAM FERDINAND METZGER
Credential	:	OD
Telephone Number	:	859-750-5642

Provider Enumeration Date	:	10/19/2020
Last Update Date	:	02/10/2022

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