Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG000535 | PA |
NPI | 1003952722 |
---|---|
Provider Name | Dr. Kenneth Joseph Hue |
First Address | Indiana, PA 15701 |
Second Address | Indiana, PA 15701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007354910004 | (05) | PA |
T28272 | (02) |