Provider Demographics
NPI:1649377177
Name:ASSOCIATES IN EYE CARE, INC.
Entity type:Organization
Organization Name:ASSOCIATES IN EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:UPCHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-387-5612
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:KY
Mailing Address - Zip Code:42533-0306
Mailing Address - Country:US
Mailing Address - Phone:606-492-2211
Mailing Address - Fax:606-676-0873
Practice Address - Street 1:3810 S HWY 27
Practice Address - Street 2:SUITE 1
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-3073
Practice Address - Country:US
Practice Address - Phone:606-678-4551
Practice Address - Fax:606-678-0972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
65397OtherOPTUMHEALTH VISION
CP0230:010OtherEYEMED
KY77012011OtherMEDICAID # FOR DR. MARK JACOBS
KY0241603OtherMEDICARE PIN FOR DR. MARK JACOBS
TN39976; 4209301OtherBCBSTN/BLUECARE/TENNCARE
KY7100209960Medicaid
KYCB8623OtherRAILROAD MEDICARE
015403OtherBLOCK VISION
KY7100010460OtherMEDICAID # FOR DR. STEPHEN MCKINLEY
KY0241609OtherMEDICARE PIN FOR DR. STEPHEN MCKINLEY
KY0241610OtherMEDICARE PIN FOR DR. FREDERICK MARTIN
KY77008167OtherMEDICAID # FOR DR. FREDERICK MARTIN
KY77901577Medicaid
KY0487990006Medicare NSC
KY2416Medicare PIN
CP0230:010OtherEYEMED
KY2416Medicare PIN