Provider Demographics
NPI:1336452630
Name:CECIL AND ASSOCIATES EYECARE PLLC
Entity Type:Organization
Organization Name:CECIL AND ASSOCIATES EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CECIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:502-633-5685
Mailing Address - Street 1:500 TAYLORSVILLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8104
Mailing Address - Country:US
Mailing Address - Phone:502-633-5685
Mailing Address - Fax:
Practice Address - Street 1:500 TAYLORSVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8104
Practice Address - Country:US
Practice Address - Phone:502-633-5685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1809DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty