| Dana S Chitwood Llc | |
|
60 S Stewart Rd Corbin KY 40701-4675 | |
| (606) 258-8888 | |
| (606) 523-5596 |
| Full Name | Dana S Chitwood Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 60 S Stewart Rd, Corbin, Kentucky |
| Authorized Official Name and Position | Dana S. Chitwood (OPTOMETRIST) |
| Authorized Official Contact | 6062588888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana S Chitwood Llc 60 S Stewart Rd Corbin KY 40701-4675 Ph: (606) 258-8888 | Dana S Chitwood Llc 60 S Stewart Rd Corbin KY 40701-4675 Ph: (606) 258-8888 |
| NPI Number | 1083889497 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 05/28/2008 |
| Medicare PECOS PAC ID | 3476623760 |
|---|---|
| Medicare Enrollment ID | O20080529000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083889497 | NPI | - | NPPES |
| 7100025430 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1700DT (Kentucky) | Primary |
| Provider Name | Dana S Chitwood |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861690992 PECOS PAC ID: 9931279320 Enrollment ID: I20080528000041 |
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