Individual
AUSTIN RAY LIFFERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1935 BLUEGRASS AVE, STE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488
Mailing address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 371-4697
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003391A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77001147
—
KY
Enumeration date
12/27/2005
Last updated
03/15/2018
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