Provider Demographics
NPI:1730598426
Name:KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY
Entity type:Organization
Organization Name:KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNES
Authorized Official - Middle Name:C
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-278-9393
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:B75
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1724
Mailing Address - Country:US
Mailing Address - Phone:859-278-9393
Mailing Address - Fax:859-278-0923
Practice Address - Street 1:333 BEACON HILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-6178
Practice Address - Country:US
Practice Address - Phone:606-784-3393
Practice Address - Fax:606-794-3763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty