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NPI Code Detail

MEDICARE: DR. JULIE A HERRON O.D.

MEDICARE: DR. JULIE A HERRON 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
1152W00000XOptometrist1491DTKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000274452OTHERKYANTHEM PIN
349287OTHERKYDAVIS ID
4K1491EOTHERKYHUMANA ID
524453OTHERKYSPECTERA ID
622-02615OTHERKYUNITED HEALTHCARE ID

General Provider Information

NPI Number : 1750444212
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIE A HERRON O.D.
Provider Business Mailing Address
First Line : 2408 LOST WILLOW CT
Second Line :
City : HEBRON
State : KY
Zip : 41048-7393
Country : US
Telephone Number : 859-384-2761
Fax Number :
Provider Business Practice Location Address
First Line : 6711 ALEXANDRIA PIKE
Second Line :
City : ALEXANDRIA
State : KY
Zip : 41001-1025
Country : US
Telephone Number : 859-635-0948
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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