Individual
JASON E CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
1800 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9663
(270) 789-2023
(270) 465-5361
Mailing address
1800 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9663
(270) 789-2023
(270) 465-5361
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1581DT
KY
Other
Enumeration date
05/31/2007
Last updated
02/28/2013
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