Organization
SOUTHEAST EYE ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA S HOWARD OD (OWNER)
(606) 248-2549
Entity
Organization
Contact information
Practice address
1403 CUMBERLAND AVE, SUITE A, BOX 979, MIDDLESBORO, KY 40965-1158
(606) 248-2549
(606) 248-9188
Mailing address
1403 CUMBERLAND AVE, SUITE A, MIDDLESBORO, KY 40965-1158
(606) 248-2549
(606) 248-9188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1082 DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7265
MEDICARE PTAN
—
Enumeration date
02/26/2007
Last updated
05/20/2011
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