Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 817DT | KY |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 0817DT | KY |
NPI | 1215917067 |
---|---|
Provider Name | Robert Thomas Mchugh |
First Address | Morehead, KY 40351-1701 |
Second Address | Morehead, KY 40351-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 13/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
77008175 | (05) | KY |
T-54549 | (02) | KY |