Provider Demographics
NPI:1619924164
Name:MAJAKEY, LEE VERNON (OD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:VERNON
Last Name:MAJAKEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 FITZGERALD CT., STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-245-3635
Mailing Address - Fax:859-245-3636
Practice Address - Street 1:1500 FITZGERALD CT., STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-245-3635
Practice Address - Fax:859-245-3636
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1042DT152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77010429Medicaid
KY9213801Medicare ID - Type Unspecified
KY77010429Medicaid
KYT54707Medicare UPIN