Individual
MR. MARCUS S MINIX SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
212 GLYNVIEW PLAZA, PRESTONSBURG, KY 41653
(606) 886-2154
Mailing address
212 GLYNVIEW PLAZA, PRESTONSBURG, KY 41653
(606) 886-2154
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
KY0407
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52800265
—
KY
05
—
52904075
—
KY
05
—
77007342
—
KY
05
—
77900702
—
KY
01
—
NPI1215905393
DR. GUSSLER
KY
01
—
NPI1780685156
DR. CRUM
KY
Enumeration date
01/08/2007
Last updated
07/09/2007
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