| |
1169 Eastern Pkwy, Ste 3334, Louisville, KY 40217-1417 | |
(502) 458-9004 | |
(502) 458-9842 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1169 Eastern Pkwy, Louisville, Kentucky |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760484307 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152WC0802X | Optometrist - Corneal And Contact Management | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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601 Broadway St Ste 10, Madison, IN 47250-3364 Ph: (812) 265-6535 | 1169 Eastern Pkwy, Ste 3334, Louisville, KY 40217-1417 Ph: (502) 458-9004 |