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Individual

DR. ALICIA HERRMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
10232 WESTPORT RD, LOUISVILLE, KY 40241-2148
(502) 339-2042
(502) 339-2044
Mailing address
PO BOX 207170, DALLAS, TX 75320-7156
(636) 200-4393
(636) 527-0766

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1266DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000313513
ANTHEM BLUE CROSS BLUE SH
KY
01
161677858
TRICARE PRIME
KY
01
19750
SPECTERA
KY
01
31675
AVESIS
KY
01
4360512
AETNA
KY
01
448070
HIGHMARK
KY
05
77012664
KY
01
911299
PASSPORT/BLOCK LOC 019488
KY
Enumeration date
09/22/2006
Last updated
10/06/2020
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