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Organization

OWENSBORO FAMILY EYE CARE CENTER PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTY SHANE TRAYLOR OD (PRESIDENT)
(270) 683-2101
Entity
Organization

Contact information

Practice address
3310 PROFESSIONAL PARK DR., SUITE 101, OWENSBORO, KY 42303-4551
(270) 683-2101
(270) 683-2507
Mailing address
3310 PROFESSIONAL PARK DR., SUITE 101, OWENSBORO, KY 42303-4551
(270) 683-2101
(270) 683-2507

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77903599
KY
Enumeration date
03/22/2006
Last updated
10/15/2013
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