Individual
LINDA DARLENE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Contact information
Practice address
1555 E NEW CIRCLE RD, SUITE 146, LEXINGTON, KY 40509-1043
(859) 266-3003
(859) 266-9504
Mailing address
1555 E NEW CIRCLE RD, SUITE 146, LEXINGTON, KY 40509-1043
(859) 266-3003
(859) 266-9504
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1069
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52000049
—
KY
Enumeration date
12/21/2006
Last updated
07/09/2007
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