Healthcare Provider Details

I. General information

NPI: 1053311589
Provider Name (Legal Business Name): ANTHONY SCOTT KEE OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 S CAROL MALONE BLVD STE A
GRAYSON KY
41143-1352
US

IV. Provider business mailing address

166 S CAROL MALONE BLVD STE A
GRAYSON KY
41143-1352
US

V. Phone/Fax

Practice location:
  • Phone: 606-474-2940
  • Fax: 606-474-2944
Mailing address:
  • Phone: 606-474-2940
  • Fax: 606-474-2944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1162DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: