Organization
MCCLOUD EYE CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON H MCCLOUD OD (OPTOMETRIST)
(606) 474-5149
Entity
Organization
Contact information
Practice address
107 E MAIN ST, GRAYSON, KY 41143-1301
(606) 474-5149
(606) 474-0648
Mailing address
107 E MAIN ST, GRAYSON, KY 41143-1301
(606) 474-5149
(606) 474-0648
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1585DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77000859
—
KY
05
—
77903649
—
KY
01
—
7987
MEDICARE GROUP #
KY
Enumeration date
11/21/2007
Last updated
12/29/2011
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