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Individual

DR. CLAY S MATTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1024 N MAIN ST, NICHOLASVILLE, KY 40356-2311
(859) 881-5444
(859) 881-3180
Mailing address
425 LANTANA PARK, LEXINGTON, KY 40515-5130
(859) 881-5444
(859) 881-3180

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1494DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000380440
BLUE CROSS BLUE SHIELD
KY
05
770000735
KY
Enumeration date
08/15/2006
Last updated
11/30/2010
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