Provider Demographics
NPI:1508867201
Name:SCHAFFIELD, SHARON M (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:SCHAFFIELD
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 1:5522 TAYLOR MILL RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR MILL
Mailing Address - State:KY
Mailing Address - Zip Code:41015-4604
Mailing Address - Country:US
Mailing Address - Phone:859-581-7200
Mailing Address - Fax:859-581-7256
Practice Address - Street 1:5522 TAYLOR MILL RD
Practice Address - Street 2:
Practice Address - City:TAYLOR MILL
Practice Address - State:KY
Practice Address - Zip Code:41015-4604
Practice Address - Country:US
Practice Address - Phone:859-581-7200
Practice Address - Fax:859-581-7256
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1131DT152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000002027OtherANTHEM
KY2200827OtherUNITED HEALTH CARE
KY4395731OtherAETNA
KY77011310Medicaid
KY45002409Medicaid
KY45002409Medicaid
KY77011310Medicaid