Provider Demographics
NPI:1457442188
Name:ASSOCIATES IN EYE CARE, INC.
Entity Type:Organization
Organization Name:ASSOCIATES IN EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:UPCHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-387-5612
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:KY
Mailing Address - Zip Code:42533-0306
Mailing Address - Country:US
Mailing Address - Phone:606-492-2211
Mailing Address - Fax:606-676-0873
Practice Address - Street 1:207 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1121
Practice Address - Country:US
Practice Address - Phone:606-549-0464
Practice Address - Fax:606-549-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100210000Medicaid
KYCB8623OtherRAILROAD MEDICARE
TNQ048371Medicaid
KY7100010460OtherMEDICAID # FOR DR. STEPHEN MCKINLEY
KY0279109OtherMEDICARE PIN FOR DR. STEPHEN MCKINLEY
KY77902161Medicaid
62082OtherOPTUMHEALTH VISION
TN174791OtherBCBSTN/BLUECARE/TENNCARE
KY77012904OtherMEDICAID # FOR DR. ERIC TODD OVERLEY
KY0279105OtherMEDICARE PIN FOR DR. ERIC TODD OVERLEY
TNCP0230:006OtherEYEMED
TN174791OtherBCBSTN/BLUECARE/TENNCARE