Carl W. Sydnor
Organization Active NPI Optometrist · Brandenburg, KY
NPI 1083810063 · NPPES record last updated Jun 13, 2008
Key facts
- NPI
- 1083810063
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1192-DT (KY)
- Legal business name
- CARL W. SYDNOR
- Practice address
- 732 High St
Brandenburg, KY 40108-1234 - Phone
- (270) 422-4241
- Fax
- (270) 422-5211
- NPI assigned
- Jun 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Carl W Sydnor, O.D.
- Title
- Owner
- Phone
- (270) 422-4241
Practitioners 1
-
Carl W. Sydnor, O.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1192-DT | KY | Yes |
Addresses
Primary practice location
732 High St
Brandenburg, KY 40108-1234
Mailing address
732 High St
Brandenburg, KY 40108-1234
Phone (270) 422-4241
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77011922 | Medicaid | KY |
Other names
- Brandenburg Eye Care
Other providers in Brandenburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.