Provider Demographics
NPI:1790035582
Name:EYES ON SOMERSET, PLLC
Entity Type:Organization
Organization Name:EYES ON SOMERSET, PLLC
Other - Org Name:20/20 VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-494-0555
Mailing Address - Street 1:PO BOX 1548
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42502-1548
Mailing Address - Country:US
Mailing Address - Phone:859-494-0555
Mailing Address - Fax:
Practice Address - Street 1:1005 W COLUMBIA ST
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2720
Practice Address - Country:US
Practice Address - Phone:606-677-2020
Practice Address - Fax:606-677-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1743DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty