Provider Demographics
NPI:1144407370
Name:LEE CAIN OD
Entity Type:Organization
Organization Name:LEE CAIN OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:606-248-3582
Mailing Address - Street 1:2145 US HIGHWAY 25 E
Mailing Address - Street 2:PO BOX 2179
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1874
Mailing Address - Country:US
Mailing Address - Phone:606-248-3582
Mailing Address - Fax:
Practice Address - Street 1:2145 US HIGHWAY 25 E
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1874
Practice Address - Country:US
Practice Address - Phone:606-248-3582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY16567OtherAVESIS
KY000000049008OtherBCBS
KY77901858Medicaid
KY9314601OtherRR MEDICARE
KYT54745Medicare UPIN