Provider Demographics
NPI:1417090531
Name:TKT OPTIQUE
Entity Type:Organization
Organization Name:TKT OPTIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-224-8080
Mailing Address - Street 1:3735 PALOMAR CENTRE DR
Mailing Address - Street 2:SUITE 50
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1147
Mailing Address - Country:US
Mailing Address - Phone:859-224-8080
Mailing Address - Fax:859-223-2913
Practice Address - Street 1:3735 PALOMAR CENTRE DR
Practice Address - Street 2:SUITE 50
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1147
Practice Address - Country:US
Practice Address - Phone:859-224-8080
Practice Address - Fax:859-223-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier