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NPI Code Detail

MEDICARE: JARROD ASHLEY MAYHEW O.D.

MEDICARE: JARROD ASHLEY MAYHEW 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
1152W00000XOptometrist1461DTKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730395187
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARROD ASHLEY MAYHEW O.D.
Provider Business Mailing Address
First Line : 2345 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8076
Country : US
Telephone Number : 270-678-4338
Fax Number : 270-678-2647
Provider Business Practice Location Address
First Line : 2345 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8076
Country : US
Telephone Number : 270-678-4338
Fax Number : 270-678-2647
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 03/04/2015

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