Provider Demographics
NPI:1649676552
Name:CLEAR OPTIKS LLC
Entity type:Organization
Organization Name:CLEAR OPTIKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-523-8367
Mailing Address - Street 1:811 CORPORATE DR
Mailing Address - Street 2:STE 101
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-5407
Mailing Address - Country:US
Mailing Address - Phone:859-523-8367
Mailing Address - Fax:859-523-8367
Practice Address - Street 1:811 CORPORATE DR
Practice Address - Street 2:STE 101
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5407
Practice Address - Country:US
Practice Address - Phone:859-523-8367
Practice Address - Fax:859-523-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK106150Medicare PIN