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Contact Information

PCD MANAGEMENT OF PADUCAH, LLC
467 JORDAN DRIVE
SUITE 101
PADUCAH, KY42001
 Phone: 270-297-2020
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for PCD MANAGEMENT OF PADUCAH, LLC

NPI # 1659998524
LBN Legal business name PCD MANAGEMENT OF PADUCAH, LLC
Authorized official CALEB TANCK - (CREDENTIALING AGENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/26/2020
Last updated 10/22/2025 - About 7 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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