Provider Demographics
NPI:1760491328
Name:KENTUCKY EYE CARE PSC
Entity Type:Organization
Organization Name:KENTUCKY EYE CARE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:IHNEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-896-5750
Mailing Address - Street 1:6400 DUTCHMANS PKWY
Mailing Address - Street 2:STE 125
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205
Mailing Address - Country:US
Mailing Address - Phone:502-896-8700
Mailing Address - Fax:502-896-0813
Practice Address - Street 1:6400 DUTCHMANS PKWY
Practice Address - Street 2:STE 125
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205
Practice Address - Country:US
Practice Address - Phone:502-896-8700
Practice Address - Fax:502-896-0813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65918864Medicaid
KY65918864Medicaid
0303350001Medicare NSC