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Organization

NGOC DO-BIZZELL OD, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NGOC C DO-BIZZELL OD (OWNER/PRESIDENT)
(502) 222-2889
Entity
Organization

Contact information

Practice address
1015 NEW MOODY LN, LA GRANGE, KY 40031-9142
(502) 222-2889
(844) 305-1011
Mailing address
1015 NEW MOODY LN, LA GRANGE, KY 40031-9142
(502) 222-2889
(502) 222-5274

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1582DTKY
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215006770
NPI
KY
05
77001022
KY
Enumeration date
07/25/2007
Last updated
07/24/2024
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