Provider Demographics
NPI:1275790636
Name:FRANKFORT EYE CENTER PSC
Entity Type:Organization
Organization Name:FRANKFORT EYE CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-682-7845
Mailing Address - Street 1:100 DIAGNOSTIC DR STE 2
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-6524
Mailing Address - Country:US
Mailing Address - Phone:502-875-9860
Mailing Address - Fax:
Practice Address - Street 1:100 DIAGNOSTIC DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6524
Practice Address - Country:US
Practice Address - Phone:502-875-9860
Practice Address - Fax:502-875-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41652207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6248910001Medicare NSC