| |
100 Highway 15 S Ste 108, Jackson, KY 41339-8895 | |
(606) 666-9393 | |
(606) 666-4131 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 100 Highway 15 S Ste 108, Jackson, Kentucky |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053054940 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
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1401 Harrodsburg Rd Ste B290, Lexington, KY 40504-1730 Ph: (859) 277-2692 | 100 Highway 15 S Ste 108, Jackson, KY 41339-8895 Ph: (606) 666-9393 |