Individual
DR. MICHAEL ANDREW DURANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
116 MINI MALL DR, BEREA, KY 40403-1170
(859) 985-0078
(859) 985-0045
Mailing address
116 MINI MALL DR, BEREA, KY 40403-1170
(859) 985-0078
(859) 985-0045
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1345DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000064776
BCBS GROUP #
KY
01
—
000000064780
BCBS
KY
01
—
1267150001
PALMETTO
KY
01
—
611344538
TAX ID #
KY
05
—
77013456
—
KY
05
—
77903276
—
KY
Enumeration date
05/15/2006
Last updated
01/23/2011
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