Provider Demographics
NPI:1689862369
Name:EYE SPECIALISTS OF LOUISVILLE, P.S.C.
Entity Type:Organization
Organization Name:EYE SPECIALISTS OF LOUISVILLE, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-897-9881
Mailing Address - Street 1:4950 NORTON HEALTHCARE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2845
Mailing Address - Country:US
Mailing Address - Phone:502-897-0667
Mailing Address - Fax:502-897-1761
Practice Address - Street 1:4121 DUTCHMANS LN
Practice Address - Street 2:SUITE 410
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4707
Practice Address - Country:US
Practice Address - Phone:502-897-9881
Practice Address - Fax:502-897-9824
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE SPECIALISTS OF LOUISVILLE, P.S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty