Individual
DR. POLLY HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
279 N GARDNER ST STE 2, SCOTTSBURG, IN 47170-1322
(812) 288-8566
(812) 284-2326
Mailing address
4000 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1524
(502) 813-8928
(502) 456-9121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002171A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22139005
MEDICARE
IN
01
—
541920013
DMERC
IN
Enumeration date
09/29/2006
Last updated
09/12/2019
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