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General NPI Number Information
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NPI Number | 1073798054
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Entity Type | Organization
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Legal Business Name | DR JOE TERRY AND ASSOCIATES, INC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 5040 FREDERICA ST STE A
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City | OWENSBORO
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State | KY
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Zip | 42301-7425
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Country | US
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Telephone | 270-685-0247
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Fax | 270-713-7932
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Provider Business Mailing Address
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Address Line | 5040 FREDERICA ST STE A
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City | OWENSBORO
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State | KY
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Zip | 42301-7425
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Country | US
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Telephone | 270-685-0247
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Fax | 270-713-7932
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOE W TERRY
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Credential | O.D.
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Telephone | 270-689-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1395DT
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License Number State | KY
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