Healthcare Provider Details

I. General information

NPI: 1962403394
Provider Name (Legal Business Name): WARD R RANSDELL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MALABU DR
LEXINGTON KY
40503-3141
US

IV. Provider business mailing address

1895 BELLEFONTE DR
LEXINGTON KY
40503-2001
US

V. Phone/Fax

Practice location:
  • Phone: 859-275-7333
  • Fax: 859-277-6421
Mailing address:
  • Phone: 859-266-2020
  • 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:
Title or Position:
Credential:
Phone: