Provider Demographics
NPI:1275725483
Name:FAMILY EYE CARE PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:FAMILY EYE CARE PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-432-7009
Mailing Address - Street 1:PO BOX 2177
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2177
Mailing Address - Country:US
Mailing Address - Phone:606-432-7009
Mailing Address - Fax:606-432-3576
Practice Address - Street 1:4219 N MAYO TRL
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3210
Practice Address - Country:US
Practice Address - Phone:606-432-7009
Practice Address - Fax:606-432-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-11
Last Update Date:2007-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier