Organization
DR TODD M MAYNARD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD MAYNARD O.D. (PRESIDENT)
(606) 298-7768
Entity
Organization
Contact information
Practice address
64 KIRK PLAZA, INEZ, KY 41224-1307
(606) 298-7768
(606) 298-4839
Mailing address
PO BOX 1307, INEZ, KY 41224-1307
(606) 298-7768
(606) 298-4839
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1295DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051567
ANTHEM BC/BS
KY
01
—
410033298
MEDICARE RAILROAD
—
05
—
7100036460
—
KY
Enumeration date
12/12/2007
Last updated
08/31/2010
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