Provider Demographics
NPI:1578884334
Name:KEVIN SNIPES, O.D. & ASSOCIATES, PSC
Entity Type:Organization
Organization Name:KEVIN SNIPES, O.D. & ASSOCIATES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNIPES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:502-327-8568
Mailing Address - Street 1:7900 SHELBYVILLE RD
Mailing Address - Street 2:STE. A15
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5451
Mailing Address - Country:US
Mailing Address - Phone:502-968-6860
Mailing Address - Fax:502-969-5293
Practice Address - Street 1:4801 OUTER LOOP
Practice Address - Street 2:STE. D648
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3201
Practice Address - Country:US
Practice Address - Phone:502-968-6860
Practice Address - Fax:502-969-5293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEVIN SNIPES, O.D. & ASSOCIATES, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1357DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty