Provider Demographics
NPI:1922106376
Name:HARRINGTON, KATHLENE FERRELL (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHLENE
Middle Name:FERRELL
Last Name:HARRINGTON
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 1:213 GATEWAY BLVD
Mailing Address - Street 2:STE 4
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901
Mailing Address - Country:US
Mailing Address - Phone:304-645-7797
Mailing Address - Fax:304-645-9086
Practice Address - Street 1:213 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901
Practice Address - Country:US
Practice Address - Phone:304-645-7797
Practice Address - Fax:304-645-9086
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV0731152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3102024-000Medicaid
WV3102024-000Medicaid
4056671Medicare ID - Type Unspecified