Organization
EYEDEAL EYECARE II PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ANDREW DURANT O.D. (OWNER OPERATOR)
(606) 877-1101
Entity
Organization
Contact information
Practice address
1370 W 5TH ST, SUITE 2, LONDON, KY 40741-1615
(606) 877-1101
(606) 878-6356
Mailing address
1370 W 5TH ST, SUITE 2, LONDON, KY 40741-1615
(606) 877-1101
(606) 878-6356
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 DURANT ID #
KY
01
—
000000202838
BCBS HENDY ID#
KY
01
—
1267150001
PALMETTO
KY
05
—
77013456
—
KY
05
—
77013639
—
KY
05
—
77903276
—
KY
Enumeration date
05/15/2006
Last updated
08/22/2020
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