Individual
TREVOR PEDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
503 N MAIN ST, LONDON, KY 40741-1217
(606) 877-1877
(606) 877-0082
Mailing address
503 N MAIN ST, LONDON, KY 40741-1217
(606) 877-1877
(606) 877-0082
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2246DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2246DT
KENTUCKY OPTOMETRY LICENSE
KY
Enumeration date
06/23/2021
Last updated
06/23/2021
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