Provider Demographics
NPI:1497447486
Name:NEUDECKER, BRITTANY TAYLOR (OD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:TAYLOR
Last Name:NEUDECKER
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 1:117 JEFFERSON TRL
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-7507
Mailing Address - Country:US
Mailing Address - Phone:256-596-0278
Mailing Address - Fax:
Practice Address - Street 1:246 POPLAR AVE STE 1
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1701
Practice Address - Country:US
Practice Address - Phone:606-679-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2315DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist