Healthcare Provider Details

I. General information

NPI: 1437189461
Provider Name (Legal Business Name): ALISON MCDONALD OVERLEY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 S LAUREL RD STE B
LONDON KY
40744-7862
US

IV. Provider business mailing address

975 S LAUREL RD STE B
LONDON KY
40744-7862
US

V. Phone/Fax

Practice location:
  • Phone: 606-878-2020
  • Fax: 606-878-2055
Mailing address:
  • Phone: 606-878-2020
  • Fax: 606-878-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1384DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: