Provider Demographics
NPI:1770740573
Name:BASTIN, ARMAND JOSEPH JR (ABOC)
Entity type:Individual
Prefix:MR
First Name:ARMAND
Middle Name:JOSEPH
Last Name:BASTIN
Suffix:JR
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3139B CANTON PIKE
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1315
Mailing Address - Country:US
Mailing Address - Phone:270-881-1110
Mailing Address - Fax:270-881-1141
Practice Address - Street 1:3139B CANTON PIKE
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1315
Practice Address - Country:US
Practice Address - Phone:270-881-1110
Practice Address - Fax:270-881-1141
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY1122156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician