Provider Demographics
NPI:1649212960
Name:KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY
Entity Type:Organization
Organization Name:KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY
Other - Org Name:KY EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-278-9393
Mailing Address - Street 1:601 PERIMETER DR
Mailing Address - Street 2:STE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4121
Mailing Address - Country:US
Mailing Address - Phone:859-278-9393
Mailing Address - Fax:859-278-0923
Practice Address - Street 1:601 PERIMETER DR
Practice Address - Street 2:STE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4121
Practice Address - Country:US
Practice Address - Phone:859-278-9393
Practice Address - Fax:859-278-0923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65912461Medicaid
KY7100226580Medicaid
KY0968700001Medicare NSC
KY7100226580Medicaid
KYCA7200Medicare PIN