Individual
MICHAEL KENT HASKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2047 HAMILTON BLVD, SOUTH BOSTON, VA 24592-2141
(434) 572-9733
(434) 572-9736
Mailing address
2047 HAMILTON BLVD, SOUTH BOSTON, VA 24592-2141
(434) 572-9733
(434) 572-9736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000062
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009206019
—
VA
01
—
0180770001
CIGNA HEALTHCARE DMERC
VA
01
—
063596
BLUE CROSS BLUE SHIELD
VA
01
—
410038621
RAILROAD MEDICARE
VA
Enumeration date
10/18/2005
Last updated
07/01/2014
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