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General NPI Number Information
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NPI Number | 1770589376
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Entity Type | Individual
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Provider Name | ARTHUR ANDREW HALEY O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 399 CAMPBELLSVILLE BY PASS RD STE 116
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-8831
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Country | US
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Telephone | 270-469-4393
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Fax | 270-469-1050
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Provider Business Mailing Address
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Address Line | 399 CAMPBELLSVILLE BY PASS RD STE 116
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-8831
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Country | US
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Telephone | 270-469-4393
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Fax | 270-469-1050
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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 | 1181DT
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License Number State | KY
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