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General NPI Number Information
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NPI Number | 1578606406
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Entity Type | Organization
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Legal Business Name | MULTICARE EYE CLINIC PLLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 44 MCCOY AVE
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City | MADISONVILLE
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State | KY
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Zip | 42431-2867
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Country | US
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Telephone | 270-825-3937
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Fax | 270-326-2020
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Provider Business Mailing Address
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Address Line | 1180 COLLEGE DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-9181
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Country | US
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Telephone | 270-825-3937
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Fax | 270-326-2020
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. TROY WAYNE CRIST
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Credential | O.D.
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Telephone | 270-825-3937
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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 | 1237DT
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License Number State | KY
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