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General NPI Number Information
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NPI Number | 1538360177
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Entity Type | Organization
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Legal Business Name | EYECARE NETWORK LTD
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 1360 MEDICAL PARK DR
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City | MAYSVILLE
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State | KY
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Zip | 41056-9621
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Country | US
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Telephone | 606-759-5341
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Fax |
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Provider Business Mailing Address
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Address Line | 1360 MEDICAL PARK DR
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City | MAYSVILLE
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State | KY
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Zip | 41056-9621
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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 | OWNER
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Name | DR. BRYAN NEAL PRATER
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Credential | M.D.
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Telephone | 606-759-5341
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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