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Individual

MR. TODD MARVIN MCGEORGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1431 CUMBERLAND AVE, MIDDLESBORO, KY 40965-1117
(606) 248-7772
(606) 248-0575
Mailing address
601 PERIMETER DR STE 200, LEXINGTON, KY 40517-4121
(859) 278-9393
(859) 278-0923

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1298DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77000107
KY
Enumeration date
01/20/2006
Last updated
10/12/2018
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