Provider Demographics
NPI:1962403394
Name:RANSDELL, WARD R (OD)
Entity type:Individual
Prefix:DR
First Name:WARD
Middle Name:R
Last Name:RANSDELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 BELLEFONTE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2001
Mailing Address - Country:US
Mailing Address - Phone:859-266-2020
Mailing Address - Fax:859-277-6421
Practice Address - Street 1:101 MALABU DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3141
Practice Address - Country:US
Practice Address - Phone:859-275-7333
Practice Address - Fax:859-277-6421
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0804DT152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000245234OtherBC/BS
KY77008043Medicaid
KY0721001Medicare ID - Type Unspecified
KY77008043Medicaid