MEDICARE: KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1093755837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY

Provider Business Mailing Address
First Line	:	1401 HARRODSBURG RD
Second Line	:	B75
City	:	LEXINGTON
State	:	KY
Zip	:	40504-1724
Country	:	US
Telephone Number	:	859-278-9393
Fax Number	:	859-278-0923

Provider Business Practice Location Address
First Line	:	1114 MCCANN DR
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1157
Country	:	US
Telephone Number	:	859-744-9393
Fax Number	:	859-744-4971

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	MR. KENNETH E WOODWORTH JR.
Credential	:
Telephone Number	:	859-278-9393

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	05/19/2021

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