Provider Demographics
NPI:1013513308
Name:JOHN KENYON AMERICAN EYE INSTITUTE LLC
Entity type:Organization
Organization Name:JOHN KENYON AMERICAN EYE INSTITUTE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:GIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-304-2520
Mailing Address - Street 1:2000 TUNNELL HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701
Mailing Address - Country:US
Mailing Address - Phone:270-304-2520
Mailing Address - Fax:
Practice Address - Street 1:2000 TUNNEL HILL RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8025
Practice Address - Country:US
Practice Address - Phone:270-304-2520
Practice Address - Fax:270-304-2519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN KENYON AMERICAN EYE INSTITUTE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-10
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical