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Contact Information

RANDALL K PUCKETT
225 HOSPITAL DR BLDG B STE 160
WINCHESTER, KY40391
 Phone: 859-744-4429
 Fax: 859-745-7702
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for RANDALL K PUCKETT · (Male)

NPI # 1326031527
Status Active
Credentials
Entity Individual
Enumeration date 08/24/2005
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 1190DT
  • KY Medicaid 77011906
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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