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General NPI Number Information
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NPI Number | 1407381387
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Entity Type | Individual
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Provider Name | NAMRATA DONTHAMSETTI O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 2250 LEESTOWN RD
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City | LEXINGTON
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State | KY
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Zip | 40511-1052
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Country | US
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Telephone | 889-281-4949
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 MEETING ST APT. 1211
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City | LEXINGTON
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State | KY
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Zip | 40509-4578
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 046.011043
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License Number State | IL
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