Provider Demographics
NPI:1881051191
Name:KENTUCKY FAMILY EYECARE PLLC
Entity type:Organization
Organization Name:KENTUCKY FAMILY EYECARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:606-878-2020
Mailing Address - Street 1:975 S LAUREL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-7862
Mailing Address - Country:US
Mailing Address - Phone:606-878-2020
Mailing Address - Fax:606-878-2055
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:2016-01-19
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY1384DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77013845Medicaid