Provider Demographics
NPI:1801958467
Name:KENTUCKY INSTITUTE FOR EYE HEALTH AND SURGERY
Entity type:Organization
Organization Name:KENTUCKY INSTITUTE FOR EYE HEALTH AND SURGERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-278-9393
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:B75
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-278-9393
Mailing Address - Fax:859-278-0923
Practice Address - Street 1:975 S LAUREL RD
Practice Address - Street 2:SUITE B
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-7862
Practice Address - Country:US
Practice Address - Phone:606-878-2020
Practice Address - Fax:606-878-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1384DT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
410040625OtherDME PROVIDER