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Individual

DR. DWIGHT L AVERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
941 N MAIN STREET, HAZARD, KY 41701
(606) 439-4010
(606) 439-0880
Mailing address
941 N MAIN ST, HAZARD, KY 41701-1377
(606) 439-4010
(606) 439-0880

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1120OT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77011203
KY
Enumeration date
11/02/2006
Last updated
11/06/2012
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