Provider Demographics
NPI:1730255605
Name:METZGER, WILLIAM FERDINAND (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FERDINAND
Last Name:METZGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3603
Mailing Address - Country:US
Mailing Address - Phone:859-750-5642
Mailing Address - Fax:859-331-1742
Practice Address - Street 1:35 AUGUSTA AVE
Practice Address - Street 2:
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-3603
Practice Address - Country:US
Practice Address - Phone:859-750-5642
Practice Address - Fax:859-331-1742
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1221DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0847374Medicaid
KY77012219Medicaid
OH0847374Medicaid
KYP00035932Medicare PIN
U21019Medicare UPIN
KY77012219Medicaid