Healthcare Provider Details

I. General information

NPI: 1144280678
Provider Name (Legal Business Name): JULIE A METZGER AUBUCHON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE A METZGER OD

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 DIXIE HWY
FLORENCE KY
41042-2007
US

IV. Provider business mailing address

6901 DIXIE HWY
FLORENCE KY
41042-2007
US

V. Phone/Fax

Practice location:
  • Phone: 859-525-1800
  • Fax: 859-525-1951
Mailing address:
  • Phone: 859-525-1800
  • Fax: 859-525-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1271DT
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number1271DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: