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NPI Code Detail

MEDICARE: AUSTIN RAY LIFFERTH OD

MEDICARE: AUSTIN RAY LIFFERTH OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist18003391AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134106636
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUSTIN RAY LIFFERTH OD
Provider Business Mailing Address
First Line : 2251 DUBOIS DR
Second Line :
City : WARSAW
State : IN
Zip : 46580-3212
Country : US
Telephone Number : 574-269-2777
Fax Number : 574-371-4697
Provider Business Practice Location Address
First Line : 1935 BLUEGRASS AVE
Second Line : STE 200
City : LOUISVILLE
State : KY
Zip : 40215-1179
Country : US
Telephone Number : 502-895-0040
Fax Number : 502-361-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 03/15/2018

Similar Medicare Providers

1730182221 — JOHN ANDREW MILLIN M.D.
Practice Location Address:
1935 BLUEGRASS AVE , SUITE 200
LOUISVILLE, KY
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1013991165 — DONALD WALTER BENNETT OD MD
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1935 BLUEGRASS AVE , SUITE 200
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1922082072 — INDER PAL SINGAL MD
Practice Location Address:
1935 BLUEGRASS AVE , ST 200
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1831173988 — LEE STANLEY PEPLINSKI OD
Practice Location Address:
1935 BLUEGRASS AVE , STE 200
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1346224409 — STEVEN MARK BLOOM MD
Practice Location Address:
1935 BLUEGRASS AVE , SUITE 200
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1578547550 — STEVEN JOHN MATTAS MD
Practice Location Address:
1935 BLUEGRASS AVE , SUITE 200
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40215-1179
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Directions to “ AUSTIN RAY LIFFERTH OD” Practice Location

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