Eric Lee Ketchum O.D.

NPI 1275820649 - Optometrist - 152W00000X

NPI Details
NPI 1275820649
Gender Male
Enumeration Date 07/06/2011
Last Updated 07/06/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
886 E LENNON DR STE 102
EMORY TX, 75440-3216, US
Phone (903) 474-9090
Fax (903) 474-9111
Business Location
886 E LENNON DR STE 102
EMORY TX, 75440-3216, US
Phone (903) 474-9090
Fax (903) 474-9111
Toxanomy
Taxonomy Code 152W00000X
License State Texas
License Number 7878T
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According to our database, Eric Lee Ketchum O.D. NPI is 1275820649, taxonomy code is 152W00000X and license number is 7878T, license state is located at Texas. Eric Lee Ketchum O.D. physically located at 886 E Lennon Dr Ste 102, Emory TX, 75440-3216. NPI Number Eric Lee Ketchum O.D. has the Individual type.

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1275820649 NPI number is provided on an as is basis without warranty of any kind. 1275820649 is maintained by the National Plan & Provider Enumeration System. The contents of Eric Lee Ketchum O.D. are for informational purposes only.