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NPI Code Detail

MEDICARE: MS. KATY M CRAFT O.D.

MEDICARE:  MS. KATY M CRAFT  O.D.
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
1152W00000XOptometrist5617OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P01692640OTHEROHRAILROAD MEDICARE - MHCPI

Other Identifiers

General Provider Information

NPI Number : 1427098078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATY M CRAFT O.D.
Provider Business Mailing Address
First Line : PO BOX 449
Second Line :
City : MARIETTA
State : OH
Zip : 45750-0449
Country : US
Telephone Number : 740-374-4500
Fax Number : 740-374-5887
Provider Business Practice Location Address
First Line : 210 N 7TH ST
Second Line : SUITE 200
City : MARIETTA
State : OH
Zip : 45750-2244
Country : US
Telephone Number : 740-376-5590
Fax Number : 740-376-5591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 10/13/2016

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Directions to “ MS. KATY M CRAFT O.D.” Practice Location

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