Individual
RYAN MICHAEL SUBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2174 DIXIE HWY, FT MITCHELL, KY 41017-2902
(859) 341-2566
(859) 341-2568
Mailing address
2174 DIXIE HWY, FT MITCHELL, KY 41017-2902
(859) 341-2566
(859) 341-2568
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
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