Individual
DR. TRACEY DIANE DEXTER-EAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
209 W 15TH ST, HOPKINSVILLE, KY 42240-2035
(270) 886-8129
(270) 886-4773
Mailing address
209 W 15TH ST, HOPKINSVILLE, KY 42240-2035
(270) 886-8129
(270) 886-4773
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1343 DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000232416
ANTHEM BCBS
KY
05
—
77001238
—
KY
Enumeration date
06/30/2006
Last updated
02/10/2020
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