Provider Demographics
NPI:1104384130
Name:ELMWOOD EYE, P.C.
Entity type:Organization
Organization Name:ELMWOOD EYE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KERCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-848-2520
Mailing Address - Street 1:1601 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-1940
Mailing Address - Country:US
Mailing Address - Phone:717-848-2520
Mailing Address - Fax:717-846-2861
Practice Address - Street 1:1601 2ND AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-1940
Practice Address - Country:US
Practice Address - Phone:717-848-2520
Practice Address - Fax:717-846-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty