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General NPI Number Information
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NPI Number | 1609997337
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Entity Type | Individual
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Provider Name | HEECHUNG KO O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 535 WELLINGTON WAY SUITE 160
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City | LEXINGTON
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State | KY
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Zip | 40503-1385
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Country | US
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Telephone | 859-275-2030
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Fax | 859-275-2130
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Provider Business Mailing Address
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Address Line | 535 WELLINGTON WAY SUITE 160
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City | LEXINGTON
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State | KY
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Zip | 40503-1385
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Country | US
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Telephone | 859-275-2030
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Fax | 859-275-2130
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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 | 1514DT
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License Number State | KY
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