Individual
DR. THEA T. SHEARER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1478DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000195501
ANTHEM
KY
05
—
77000388
—
KY
01
—
OP0933
EYE MED
KY
Enumeration date
08/10/2005
Last updated
02/07/2011
Update your record
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