Provider Demographics
NPI:1518179589
Name:ADVANCED EYE CARE PSC
Entity Type:Organization
Organization Name:ADVANCED EYE CARE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABOR
Authorized Official - Middle Name:G
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-473-4835
Mailing Address - Street 1:4139 CADILLAC CT STE 200
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-1578
Mailing Address - Country:US
Mailing Address - Phone:502-473-4835
Mailing Address - Fax:502-473-4836
Practice Address - Street 1:3430 NEWBURG RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2497
Practice Address - Country:US
Practice Address - Phone:502-473-4835
Practice Address - Fax:502-473-4836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY31581207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65932246Medicaid
KY1106065OtherPASSPORT
KY65932246Medicaid
CH8069Medicare PIN