Provider Demographics
NPI:1902110638
Name:HARLAN, AUBREY SMITH (OD)
Entity Type:Individual
Prefix:MS
First Name:AUBREY
Middle Name:SMITH
Last Name:HARLAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2845 FARRELL CRES
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1393
Mailing Address - Country:US
Mailing Address - Phone:270-926-3297
Mailing Address - Fax:270-926-7325
Practice Address - Street 1:2845 FARRELL CRES
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1393
Practice Address - Country:US
Practice Address - Phone:270-926-3297
Practice Address - Fax:270-926-7325
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1812DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist