Provider Demographics
NPI:1154415115
Name:STRATTON, DAWN C (OD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:C
Last Name:STRATTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 WELLINGTON WAY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1385
Mailing Address - Country:US
Mailing Address - Phone:859-275-2030
Mailing Address - Fax:859-275-2130
Practice Address - Street 1:535 WELLINGTON WAY
Practice Address - Street 2:SUITE 160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1385
Practice Address - Country:US
Practice Address - Phone:859-275-2030
Practice Address - Fax:859-275-2130
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1287DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6166580001Medicare NSC