Provider Demographics
NPI:1306848676
Name:ANDREWS, BILLY W (OD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:W
Last Name:ANDREWS
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:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:HORSE CAVE
Mailing Address - State:KY
Mailing Address - Zip Code:42749-0180
Mailing Address - Country:US
Mailing Address - Phone:270-786-2085
Mailing Address - Fax:270-786-1215
Practice Address - Street 1:1483 S DIXIE ST
Practice Address - Street 2:
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1457
Practice Address - Country:US
Practice Address - Phone:270-786-2085
Practice Address - Fax:270-786-1215
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1075-DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000049243OtherANTHEM
KY611158844OtherHUMANA
KY000000006950OtherCHA
KY015987OtherBLOCK VISION
KY77010759Medicaid
KYT54729Medicare UPIN
KY77010759Medicaid
KY9241301Medicare PIN
KY0131260001Medicare NSC
KY000000049243OtherANTHEM
KY410007775Medicare PIN