Individual
DR. AYALA M LANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
6812 DIXIE HWY, LOUISVILLE, KY 40258-3914
(502) 933-7986
(502) 933-2652
Mailing address
4000 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1524
(502) 459-2020
(502) 456-9121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00641400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K252500
MEDICARE
KY
05
—
PENDING
—
KY
Enumeration date
08/01/2012
Last updated
06/11/2019
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