Healthcare Provider Details

I. General information

NPI: 1922281732
Provider Name (Legal Business Name): WARD R RANSDELL OD PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MALABU DR
LEXINGTON KY
40503-3141
US

IV. Provider business mailing address

101 MALABU DR
LEXINGTON KY
40503-3141
US

V. Phone/Fax

Practice location:
  • Phone: 859-275-7333
  • Fax: 859-277-6421
Mailing address:
  • Phone: 859-275-7333
  • Fax: 859-277-6421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberKY0804DT
License Number StateKY

VIII. Authorized Official

Name: DR. WARD R RANSDELL
Title or Position: OWNER
Credential: OD
Phone: 859-275-7333