Individual
MATTHEW TESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
640 W HIGHWAY 92 STE 3, WILLIAMSBURG, KY 40769-1936
(606) 549-0464
(606) 532-1773
Mailing address
PO BOX 296, FERGUSON, KY 42533-0296
(606) 492-2211
(606) 676-0873
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3562
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023674488
EYEMED
—
01
—
5764048
ANTHEM BCBS OF KY
—
01
—
6260267
BCBS OF TN
—
01
—
6332209
AETNA
—
05
—
7100652140
—
KY
01
—
K315180
CGS DME
—
01
—
Q00166483
RR MEDICARE
KY
01
—
Q00181758
RR MEDICARE
TN
05
—
Q055012
—
TN
Enumeration date
05/11/2019
Last updated
05/11/2026
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