Organization
EDMONTON FAMILY VISION CENTER PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT N WHITLOW II O.D. (CEO)
(270) 432-0123
Entity
Organization
Contact information
Practice address
1406 W STOCKTON ST, EDMONTON, KY 42129-8125
(270) 432-0123
(270) 432-5899
Mailing address
1406 W STOCKTON ST, EDMONTON, KY 42129-8125
(270) 432-0123
(270) 432-5899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1226DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77903250
—
KY
Enumeration date
10/24/2007
Last updated
02/20/2017
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