Provider Demographics
NPI:1215987391
Name:LAMEIER, KENNETH A (OD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:A
Last Name:LAMEIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-1025
Mailing Address - Country:US
Mailing Address - Phone:859-635-1848
Mailing Address - Fax:859-635-1941
Practice Address - Street 1:6711 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1025
Practice Address - Country:US
Practice Address - Phone:859-635-1848
Practice Address - Fax:859-635-1941
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1321DT152W00000X
OH4658T1433174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200830680Medicaid
KY77540318Medicaid
000000385318OtherBCBS FACET
OH0381591Medicaid
OHLA4181671Medicare PIN
000000385318OtherBCBS FACET