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Individual

DR. GUADALUPE ANGELICA MEJIA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
301 E MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1511
(502) 852-5466
(502) 852-4947
Mailing address
501 E BROADWAY STE 290, LOUISVILLE, KY 40202-2040
(502) 217-8221
(502) 217-5056

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
007185
NY
152W00000X
Optometrist
Primary
1750DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100114440
KY
Enumeration date
07/13/2007
Last updated
10/24/2011
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