| |
301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | |
(502) 852-5466 | |
(502) 588-0553 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 301 E Muhammad Ali Blvd, Louisville, Kentucky |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760813919 | NPI | - | NPPES |
65937443 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
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Po Box 909, Louisville, KY 40201-0909 Ph: (502) 588-0320 | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 Ph: (502) 852-5466 |