Provider Demographics
NPI:1215006770
Name:DO-BIZZELL, NGOC C (OD)
Entity Type:Individual
Prefix:DR
First Name:NGOC
Middle Name:C
Last Name:DO-BIZZELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 NEW MOODY LN
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-9142
Mailing Address - Country:US
Mailing Address - Phone:502-222-2889
Mailing Address - Fax:502-222-5274
Practice Address - Street 1:1015 NEW MOODY LN
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9142
Practice Address - Country:US
Practice Address - Phone:502-222-2889
Practice Address - Fax:502-222-5274
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1582DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist