Provider Demographics
NPI:1043267065
Name:EYE CONSULTANTS OF KENTUCKY PSC
Entity Type:Organization
Organization Name:EYE CONSULTANTS OF KENTUCKY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-263-3030
Mailing Address - Street 1:120 N EAGLE CREEK DR STE 211
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1827
Mailing Address - Country:US
Mailing Address - Phone:859-263-3030
Mailing Address - Fax:859-263-2491
Practice Address - Street 1:120 N EAGLE CREEK DR STE 211
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1827
Practice Address - Country:US
Practice Address - Phone:859-263-3030
Practice Address - Fax:859-263-2491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0777990002Medicare NSC