Organization
CENTRAL KENTUCKY OPTOMETRIC ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA M HOLLINGSWORTH-CECCONI OD (SECTREAS)
(270) 692-1871
Entity
Organization
Contact information
Practice address
310 W HIGH ST, LEBANON, KY 40033-1428
(270) 692-1871
(270) 692-6785
Mailing address
310 W HIGH ST, LEBANON, KY 40033-1428
(270) 692-1871
(270) 692-6785
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902843378
RAILROAD MEDICARE
KY
05
—
77903391
—
KY
Enumeration date
06/02/2006
Last updated
01/26/2009
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