Dr. Mark D Stovall, PSC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR. MARK D STOVALL, PSC

Doing business as

Drs Vance and Stovall, PSC

Practice address

120 W Market St
Louisville, KY 40202-1332

Phone

(502) 585-2020

Fax

(502) 585-1797

NPI assigned

Jun 1, 2007

Last updated

Oct 4, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark D Stovall, ODNPI 1609823905

Title

Owner

Phone

(502) 585-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Drs Vance and Stovall, PSC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark D Stovall, OD

  • Optometrist
  • Louisville, KY
  • NPI 1609823905
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1467654475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021332",
            "telephone_number": "502-585-2020",
            "fax_number": "502-585-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021332",
            "telephone_number": "502-585-2020",
            "fax_number": "502-585-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK D STOVALL, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "STOVALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-585-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100158840",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK4506",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Vance and Stovall, PSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Louisville, KY
• Providers in Louisville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.