Organization
STEVEN KLECKER
Active
Parent organization
STEVEN KLECKER
Other names
STEVEN KLECKER OPTOMETRIST
Organization subpart
Yes
Provider details
NPI number
Legal business name
STEVEN KLECKER
Authorized official
STEVEN AMBROSE KLECKER O.D. (OWNER)
(859) 269-6921
Entity
Organization
Contact information
Practice address
1555 E NEW CIRCLE RD STE 146, LEXINGTON, KY 40509-1044
(859) 269-6921
(859) 266-9504
Mailing address
1555 E NEW CIRCLE RD STE 146, LEXINGTON, KY 40509-1044
(859) 269-6921
(859) 266-9504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KY844DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77008449
—
KY
01
—
9836
MEDICARE GROUP ID
—
Enumeration date
02/15/2008
Last updated
12/10/2014
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