Provider Demographics
NPI:1699305417
Name:REGINA COLEMAN COMPTON, OD., PSC
Entity type:Organization
Organization Name:REGINA COLEMAN COMPTON, OD., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-886-2020
Mailing Address - Street 1:338 N. ARNOLD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PRESTONBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1285
Mailing Address - Country:US
Mailing Address - Phone:606-886-2020
Mailing Address - Fax:606-886-2020
Practice Address - Street 1:338 N. ARNOLD AVENUE
Practice Address - Street 2:
Practice Address - City:PRESTONBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1285
Practice Address - Country:US
Practice Address - Phone:606-886-2020
Practice Address - Fax:606-886-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty