Individual
DR. MARTY SHANE TRAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3310 PROFESSIONAL PARK, SUITE 101, OWENSBORO, KY 42303-4551
(270) 683-2101
(270) 683-2507
Mailing address
3310 PROFESSIONAL PARK, SUITE 101, OWENSBORO, KY 42303-4551
(270) 683-2101
(270) 683-2507
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1492DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77000297
—
KY
Enumeration date
03/22/2006
Last updated
07/27/2012
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