Provider Demographics
NPI:1962615419
Name:THE EYE CENTER OF LEXINGTON, PLLC
Entity type:Organization
Organization Name:THE EYE CENTER OF LEXINGTON, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:502-633-7310
Mailing Address - Street 1:500 TAYLORSVILLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8104
Mailing Address - Country:US
Mailing Address - Phone:502-633-7310
Mailing Address - Fax:502-633-0367
Practice Address - Street 1:500 TAYLORSVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8104
Practice Address - Country:US
Practice Address - Phone:502-633-7310
Practice Address - Fax:502-633-0367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1572DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8895Medicare ID - Type UnspecifiedGROUP NUMBER