Organization Name: | MEDICAL VISION GROUP, PSC |
NPI Number: | 1003941923 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JITANDER S DUDEE (MEDICAL DIRECTOR) |
Mailing Address: | 2459 Nicholasville Rd Lexington |
State: | KY US |
Postal Code: | 405033158 |
Phone Number: | 8592789486 |
Fax Number: | 8885003329 |
NPI Enumeration Date: | 02/22/2007 |
NPI Last Update Date: | 03/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 30460 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |