Provider Demographics
NPI:1295899227
Name:FLESHMAN, TODD (OD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:FLESHMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:181 HIGHWAY 44 E
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6081
Mailing Address - Country:US
Mailing Address - Phone:502-779-3002
Mailing Address - Fax:502-736-4490
Practice Address - Street 1:10639 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-4349
Practice Address - Country:US
Practice Address - Phone:502-933-9200
Practice Address - Fax:502-736-4490
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1240DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77012409Medicaid
KY77012409Medicaid
KYU33745Medicare UPIN