Provider Demographics
NPI:1235735804
Name:JOHN KENYON AMERICAN EYE INSTITUTE, LLC
Entity Type:Organization
Organization Name:JOHN KENYON AMERICAN EYE INSTITUTE, LLC
Other - Org Name:EYE SURGERY CENTER OF ELIZABETHTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:GIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-304-2520
Mailing Address - Street 1:2000 TUNNEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8025
Mailing Address - Country:US
Mailing Address - Phone:270-304-2520
Mailing Address - Fax:
Practice Address - Street 1:2000 TUNNEL HILL RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8025
Practice Address - Country:US
Practice Address - Phone:270-304-2520
Practice Address - Fax:270-304-2519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN KENYON AMERICAN EYE INSTITUTE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-09
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty