Provider Demographics
NPI:1730640152
Name:LAWRENCEBURG EYE CENTER, LLC
Entity Type:Organization
Organization Name:LAWRENCEBURG EYE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-584-8354
Mailing Address - Street 1:403 WALNUT ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-2411
Mailing Address - Country:US
Mailing Address - Phone:812-537-2020
Mailing Address - Fax:
Practice Address - Street 1:403 WALNUT ST STE A
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2411
Practice Address - Country:US
Practice Address - Phone:812-537-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty