Provider Demographics
NPI:1053054940
Name:FLYING EYE PLLC
Entity Type:Organization
Organization Name:FLYING EYE PLLC
Other - Org Name:KENTUCKY EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING/CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-338-8590
Mailing Address - Street 1:1401 HARRODSBURG RD STE B290
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1730
Mailing Address - Country:US
Mailing Address - Phone:859-277-2692
Mailing Address - Fax:859-277-9275
Practice Address - Street 1:100 HIGHWAY 15 S STE 108
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-8895
Practice Address - Country:US
Practice Address - Phone:606-666-9393
Practice Address - Fax:606-666-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty