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112 E Mcmurtry Ave, Hartford, KY 42347-1634 | |
(270) 298-7623 | |
(270) 298-7624 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 112 E Mcmurtry Ave, Hartford, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275725152 | NPI | - | NPPES |
410032987 | Other | KY | RAILROAD MEDICARE IN HART |
410032989 | Other | KY | RAILROAD MEDICARE IN MORG |
02144 | Other | KY | SPECTERA IN HARTFORD |
77013720 | Medicaid | KY | |
000000041898 | Other | KY | BLUE CROSS/BLUE SHIELD |
1524171 | Other | KY | UMWA |
000000041897 | Other | KY | BLUE CROSS IN MORGANTOWN |
02145 | Other | KY | SPECTERA MORGANTOWN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1372DT (Kentucky) | Primary |
Provider Name | Wallace Cohron |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811977937 PECOS PAC ID: 0345357067 Enrollment ID: I20120224000785 |
Mailing Address | Practice Location Address |
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112 E Mcmurtry Ave, Hartford, KY 42347-1634 Ph: (270) 298-7623 | 112 E Mcmurtry Ave, Hartford, KY 42347-1634 Ph: (270) 298-7623 |