Carol Lynn Kirk
Technician/Technologist, Optician in Logan, OH. Individual provider (NPI-1).
NPI number1760189765
StatusActive
Last updated in NPPESFeb 9, 2023
Details
- NPI
- 1760189765
- Entity type
- Individual (NPI-1)
- Name
- Carol Lynn Kirk
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 9, 2023
- Certification date
- Feb 9, 2023
- Last updated
- Feb 9, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | op.12205-sc | OH | Yes |
Practice location
12910 State Route 664 SLogan, OH 43138-8564
Phone 740-380-1939
Mailing address
12910 State Route 664 SLogan, OH 43138-8564
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Other Optician providers in Logan, OH
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