Provider Demographics
NPI:1437189461
Name:OVERLEY, ALISON MCDONALD (OD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MCDONALD
Last Name:OVERLEY
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 1:975 S LAUREL RD STE B
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-7862
Mailing Address - Country:US
Mailing Address - Phone:606-878-2020
Mailing Address - Fax:606-878-2055
Practice Address - Street 1:975 S LAUREL RD STE B
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-7862
Practice Address - Country:US
Practice Address - Phone:606-878-2020
Practice Address - Fax:606-878-2055
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1384DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77013845Medicaid
KYU70137Medicare UPIN
KY77013845Medicaid
KY0968700005Medicare NSC
KY0329707Medicare PIN