Provider Demographics
NPI:1841376480
Name:CAIN, LLOYD LEE JR (OD)
Entity type:Individual
Prefix:
First Name:LLOYD
Middle Name:LEE
Last Name:CAIN
Suffix:JR
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 1:2145 US HIGHWAY 25 E
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1874
Mailing Address - Country:US
Mailing Address - Phone:606-248-3582
Mailing Address - Fax:
Practice Address - Street 1:2145 US HIGHWAY 25 E
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1874
Practice Address - Country:US
Practice Address - Phone:606-248-3582
Practice Address - Fax:606-248-0014
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1103DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77011039Medicaid
KY000000049007OtherBCBS
55219OtherDAVIS VISION
410006579OtherRR MEDICARE
KY000000049007OtherBCBS
KY0562760001Medicare NSC
KY9256001Medicare PIN