# MR. MARCUS S MINIX SR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1487702403
- **Gender:** Man
- **Credential:** OPTICIAN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | KY0407 | KY | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 52800265 | — | KY |
| 05 | — | 52904075 | — | KY |
| 05 | — | 77007342 | — | KY |
| 05 | — | 77900702 | — | KY |
| 01 | — | NPI1215905393 | DR. GUSSLER | KY |
| 01 | — | NPI1780685156 | DR. CRUM | KY |