Provider Demographics
NPI:1235138157
Name:COLWELL, STEVEN R (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:COLWELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2465 NICHOLASVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3111
Mailing Address - Country:US
Mailing Address - Phone:859-278-7462
Mailing Address - Fax:859-278-7464
Practice Address - Street 1:2465 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3111
Practice Address - Country:US
Practice Address - Phone:859-278-7462
Practice Address - Fax:859-278-7464
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 798 DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist