Provider Demographics
NPI:1285689166
Name:EYE HEALTH SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:EYE HEALTH SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BROWN-MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:606-677-0377
Mailing Address - Street 1:2835 S HIGHWAY 27
Mailing Address - Street 2:STE 196
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-3042
Mailing Address - Country:US
Mailing Address - Phone:606-677-0377
Mailing Address - Fax:606-677-6542
Practice Address - Street 1:165 PARKERS MILL WAY
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-4151
Practice Address - Country:US
Practice Address - Phone:606-677-0377
Practice Address - Fax:606-677-6542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77903615Medicaid
KY77903615Medicaid
KYU91610Medicare UPIN
KY4731400001Medicare NSC