Provider Demographics
NPI:1700037629
Name:RANDALL C LAMBIRTH II OD & ASSOCIATES PSC
Entity Type:Organization
Organization Name:RANDALL C LAMBIRTH II OD & ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAMBIRTH
Authorized Official - Suffix:II
Authorized Official - Credentials:OD
Authorized Official - Phone:859-271-6194
Mailing Address - Street 1:161 LEXINGTON GREEN CIR
Mailing Address - Street 2:SUITE B6
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3325
Mailing Address - Country:US
Mailing Address - Phone:859-271-6194
Mailing Address - Fax:859-271-4399
Practice Address - Street 1:161 LEXINGTON GREEN CIR
Practice Address - Street 2:SUITE B6
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3325
Practice Address - Country:US
Practice Address - Phone:859-271-6194
Practice Address - Fax:859-271-4399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANDALL C LAMBIRTH II OD & ASSOCIATES PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-09
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1485DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty