Provider Demographics
NPI:1497925713
Name:MUHA OPTOMETRIC GROUP, PLLC
Entity Type:Organization
Organization Name:MUHA OPTOMETRIC GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:MUHA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-492-0162
Mailing Address - Street 1:3097 CAVERSHAM PARK LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8501
Mailing Address - Country:US
Mailing Address - Phone:859-492-0162
Mailing Address - Fax:
Practice Address - Street 1:2233 FLEMINGSBURG ROAD
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-784-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1590DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty