Provider Demographics
NPI:1700143377
Name:SCHWARTZ, ERIC (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2807
Mailing Address - Country:US
Mailing Address - Phone:502-931-8945
Mailing Address - Fax:
Practice Address - Street 1:5020 NORTON HEALTHCARE BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2835
Practice Address - Country:US
Practice Address - Phone:502-420-0173
Practice Address - Fax:502-420-0174
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1856DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100218320Medicaid