Provider Demographics
NPI:1073666343
Name:HATCHER, LINDA (OPTHALMIC DISPENSER)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:HATCHER
Suffix:
Gender:F
Credentials:OPTHALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 POPLAR AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-1701
Mailing Address - Country:US
Mailing Address - Phone:606-679-8469
Mailing Address - Fax:606-678-8891
Practice Address - Street 1:246 POPLAR AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1701
Practice Address - Country:US
Practice Address - Phone:606-679-8469
Practice Address - Fax:606-678-8891
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY498156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY180021 0118OtherNVA PROVIDER
KY52800950Medicaid
KY52904984Medicaid
KY33451OtherAVESIS PROVIDER ID
KY246909OtherCLARITY PROVIDER ID
KY10199OtherSPECTERA INSURANCE PROVID
KY50525OtherDAVIS VISION PROVIDER
KY000000340307OtherBCBS PROVIDER NUMBER
KY1176629OtherCHA HEALTH PROVIDER NUMBE
KYOP1414OtherEYEMED PROVIDER
KY5272960001Medicare NSC