Organization
DR. MARK D STOVALL, PSC
Active
Other names
Drs Vance and Stovall, PSC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D STOVALL OD (OWNER)
(502) 585-2020
Entity
Organization
Contact information
Practice address
120 W MARKET ST, LOUISVILLE, KY 40202-1332
(502) 585-2020
(502) 585-1797
Mailing address
120 W MARKET ST, LOUISVILLE, KY 40202-1332
(502) 585-2020
(502) 585-1797
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100158840
—
KY
01
—
CK4506
RAILROAD MEDICARE
KY
Enumeration date
06/01/2007
Last updated
10/04/2016
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