Provider Demographics
NPI:1003136466
Name:M ANDREW DURANT OD PLLC
Entity Type:Organization
Organization Name:M ANDREW DURANT OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DURANT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-682-3753
Mailing Address - Street 1:1213 YORKSHIRE ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-8309
Mailing Address - Country:US
Mailing Address - Phone:859-985-0078
Mailing Address - Fax:859-985-0045
Practice Address - Street 1:116 MINI MALL DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1170
Practice Address - Country:US
Practice Address - Phone:859-985-0078
Practice Address - Fax:859-985-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2011-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty