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General NPI Number Information
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NPI Number | 1689874885
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Entity Type | Organization
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Legal Business Name | NGOC DO-BIZZELL OD, PSC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 1015 NEW MOODY LN
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City | LA GRANGE
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State | KY
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Zip | 40031-9142
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Country | US
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Telephone | 502-222-2889
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Fax | 844-305-1011
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Provider Business Mailing Address
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Address Line | 1015 NEW MOODY LN
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City | LA GRANGE
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State | KY
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Zip | 40031-9142
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Country | US
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Telephone | 502-222-2889
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Fax | 502-222-5274
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | NGOC C DO-BIZZELL
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Credential | OD
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Telephone | 502-222-2889
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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 | 1582DTKY
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License Number State | KY
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