Organization
WM DWAYNE SIZEMORE OD PSC
Active
Other names
Eye Care Cntr
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM DWAYNE SIZEMORE O.D. (OWNER)
(606) 633-5200
Entity
Organization
Contact information
Practice address
29 MAPLE ST, WHITESBURG, KY 41858-7494
(606) 633-5200
(606) 633-1500
Mailing address
29 MAPLE ST, WHITESBURG, KY 41858-7494
(606) 633-5200
(606) 633-1500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
968DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048484
BCBS
KY
01
—
0624470001
DMERC
KY
01
—
1417025
UMWA
KY
01
—
3155
CHA
KY
01
—
410009550
RAILROAD MEDICARE PIN
KY
05
—
77901627
—
KY
01
—
C13977
RAILROAD MEDICARE
KY
Enumeration date
03/10/2007
Last updated
08/27/2008
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