Provider Demographics
NPI:1427751155
Name:MLD EYECARE
Entity type:Organization
Organization Name:MLD EYECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUGGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-605-2214
Mailing Address - Street 1:1028 N COLLEGE ST STE 8B
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-2227
Mailing Address - Country:US
Mailing Address - Phone:859-605-2214
Mailing Address - Fax:859-402-2606
Practice Address - Street 1:1028 N COLLEGE ST STE 8B
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-2227
Practice Address - Country:US
Practice Address - Phone:859-605-2214
Practice Address - Fax:859-402-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty