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Individual

DR. WALLACE TODD COHRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
221 W GL SMITH ST, MORGANTOWN, KY 42261-1007
(270) 526-6800
(270) 526-5462
Mailing address
221 W GL SMITH ST, PO BOX 1007, MORGANTOWN, KY 42261-1007
(270) 526-6800
(270) 526-5462

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1372DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000041897
BLUE CROSS
KY
01
000000041898
BLUE CROSS/BLU SHIELD
KY
01
02144
SPECTERA IN HARTFORD
KY
01
02145
SPECTERA IN MORGANTOWN
KY
01
1524171
UMWA FUNDS
KY
01
410032987
RAILROAD MEDICARE IN HART
KY
01
410032989
RAILROAD MEDICARE IN MORG
KY
05
77013720
KY
Enumeration date
01/17/2006
Last updated
02/10/2012
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