MEDICARE: DR. BILLY W ANDREWS O.D.

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	1075-DT	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000049243	OTHER	KY	ANTHEM
2	611158844	OTHER	KY	HUMANA
3	000000006950	OTHER	KY	CHA
4	015987	OTHER	KY	BLOCK VISION
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306848676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BILLY W ANDREWS O.D.

Provider Business Mailing Address
First Line	:	PO BOX 180
Second Line	:
City	:	HORSE CAVE
State	:	KY
Zip	:	42749-0180
Country	:	US
Telephone Number	:	270-786-2085
Fax Number	:	270-786-1215

Provider Business Practice Location Address
First Line	:	1483 S DIXIE ST
Second Line	:
City	:	HORSE CAVE
State	:	KY
Zip	:	42749-1457
Country	:	US
Telephone Number	:	270-786-2085
Fax Number	:	270-786-1215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	01/05/2012

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