Individual
RYAN MICHAEL SUBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1753DT
KY
152W00000X
Optometrist
5663
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000579103
ANTHEM
KY
01
—
1753DT
KENTUCKY LICENSE
KY
01
—
5663
STATE LICENSE
OH
05
—
7100057440
—
KY
05
—
7100172260
—
KY
Enumeration date
10/03/2006
Last updated
11/04/2011
Update your record
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