Provider Demographics
NPI:1093853483
Name:KENTUCKY EYE INSTITUTE FOR EYE HEALTH & SURGERY
Entity Type:Organization
Organization Name:KENTUCKY EYE INSTITUTE FOR EYE HEALTH & SURGERY
Other - Org Name:RANDY STEELE O.D. & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:RANDY
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:606-286-6010
Mailing Address - Street 1:333 BEACON HILL RD
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-6178
Mailing Address - Country:US
Mailing Address - Phone:606-784-3288
Mailing Address - Fax:606-784-3296
Practice Address - Street 1:333 BEACON HILL RD
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-6178
Practice Address - Country:US
Practice Address - Phone:606-784-3288
Practice Address - Fax:606-784-3296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENTUCKY EYE INSTITUTE HEALTH AND SURGERY PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77010270Medicaid
KY77010353Medicaid
KY0968700002Medicare NSC
KY77010270Medicaid
KY77010353Medicaid