Individual
DR. DARRELL L TADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
760 CAMPBELL LN STE 120, BOWLING GREEN, KY 42104-1085
(270) 781-3937
(270) 783-3435
Mailing address
760 CAMPBELL LN STE 120, BOWLING GREEN, KY 42104-1085
(270) 781-3937
(270) 783-3435
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1142DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77011427
—
KY
Enumeration date
01/18/2007
Last updated
02/03/2014
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