Individual
KEVIN BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2724 NASHVILLE RD, BOWLING GREEN, KY 42101-4000
(270) 781-5111
(270) 936-6026
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1578DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77000958
—
KY
Enumeration date
12/21/2006
Last updated
10/05/2016
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