MEDICARE: DR. BRYAN WILLIAM METZGER 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
1	152W00000X	Optometrist	2216DT	KY

General Provider Information

NPI Number	:	1982294559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN WILLIAM METZGER OD

Provider Business Mailing Address
First Line	:	7517 ALEXANDRIA PIKE
Second Line	:
City	:	ALEXANDRIA
State	:	KY
Zip	:	41001-1041
Country	:	US
Telephone Number	:	859-635-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	7517 ALEXANDRIA PIKE
Second Line	:
City	:	ALEXANDRIA
State	:	KY
Zip	:	41001-1041
Country	:	US
Telephone Number	:	859-635-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	01/19/2021

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