Individual
W DOUGLAS BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 SHAKER DRIVE, SUITE 120, LEXINGTON, KY 40504-3674
(859) 278-8443
Mailing address
715 SHAKER DRIVE, SUITE 120, LEXINGTON, KY 40504-3674
(859) 278-8443
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21381
KY
Other
Enumeration date
07/20/2006
Last updated
05/05/2008
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