Provider Demographics
NPI:1013462134
Name:WEBER WEST EYE CARE, PSC
Entity Type:Organization
Organization Name:WEBER WEST EYE CARE, PSC
Other - Org Name:MECCA EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-329-2243
Mailing Address - Street 1:2119 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7733
Mailing Address - Country:US
Mailing Address - Phone:606-329-2243
Mailing Address - Fax:606-324-2395
Practice Address - Street 1:2119 CARTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7733
Practice Address - Country:US
Practice Address - Phone:606-329-2243
Practice Address - Fax:606-324-2395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2020DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty