Provider Demographics
NPI:1609296490
Name:KIRKPATRICK, MARIA (OD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:KIRKPATRICK
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 1:138 E REYNOLDS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-1258
Mailing Address - Country:US
Mailing Address - Phone:859-879-3665
Mailing Address - Fax:859-879-3662
Practice Address - Street 1:138 E REYNOLDS RD
Practice Address - Street 2:STE 101
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1258
Practice Address - Country:US
Practice Address - Phone:859-273-2020
Practice Address - Fax:859-272-8089
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1925DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist