Provider Demographics
NPI:1649522541
Name:DAWN C STRATTON OD PSC
Entity type:Organization
Organization Name:DAWN C STRATTON OD PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:C
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-275-2030
Mailing Address - Street 1:535 WELLINGTON WAY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1385
Mailing Address - Country:US
Mailing Address - Phone:859-275-2030
Mailing Address - Fax:859-275-2130
Practice Address - Street 1:535 WELLINGTON WAY
Practice Address - Street 2:SUITE 160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1385
Practice Address - Country:US
Practice Address - Phone:859-275-2030
Practice Address - Fax:859-275-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1287DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6166580001Medicare NSC