Individual
DR. FREDDIE MICHAEL MAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD OPTOMETRIST
Contact information
Practice address
1601 WEST EVERLY BROTHERS BLVD, CENTRAL CITY, KY 42330-0676
(270) 754-4515
(270) 754-2547
Mailing address
PO BOX 676, CENTRAL CITY, KY 42330-0676
(270) 754-4515
(270) 754-2547
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
906DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000319883
ANTHEM BLUE CROSS
KY
05
—
77009066
—
KY
01
—
KY0906
EYEMED
—
Enumeration date
11/02/2005
Last updated
06/18/2013
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