Provider Demographics
NPI:1962607267
Name:GASKIN, WHITNEY LEIGH (OD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:LEIGH
Last Name:GASKIN
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 1:3200 KEN BALE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-6025
Mailing Address - Country:US
Mailing Address - Phone:270-745-0038
Mailing Address - Fax:270-745-0038
Practice Address - Street 1:3200 KEN BALE BLVD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-6025
Practice Address - Country:US
Practice Address - Phone:270-745-0038
Practice Address - Fax:270-745-0038
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1703DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100010550Medicaid