Healthcare Provider Details

I. General information

NPI: 1881710713
Provider Name (Legal Business Name): RICHARDSON VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 ALEXANDRIA DR
LEXINGTON KY
40504-3111
US

IV. Provider business mailing address

1757 ALEXANDRIA DR
LEXINGTON KY
40504-3111
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-4201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: TED RICHARDSON
Title or Position: OWNER
Credential:
Phone: 859-278-4201