Dr Todd M Maynard PSC

Organization Active NPI Optometrist · Inez, KY

NPI 1306029384 · NPPES record last updated Aug 31, 2010

Key facts

NPI
1306029384
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
1295DT (KY)
Legal business name
DR TODD M MAYNARD PSC
Practice address
64 Kirk Plaza
Inez, KY 41224-1307
Phone
(606) 298-7768
Fax
(606) 298-4839
NPI assigned
Dec 12, 2007
Organization subpart
No

Authorized official

Name
Todd Maynard, O.D.
Title
President
Phone
(606) 298-7768

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X 1295DT KY Yes

Addresses

Primary practice location

64 Kirk Plaza
Inez, KY 41224-1307

Mailing address

PO Box 1307
Inez, KY 41224-1307
Phone (606) 298-7768

Other identifiers

IdentifierTypeStateIssuer
000000051567OtherKYANTHEM BC/BS
7100036460MedicaidKY
410033298OtherMEDICARE RAILROAD

Other providers in Inez, KY

All providers in Inez, KY · Optometrist in Kentucky

Sources for this page

Verify at the official NPI Registry.