Healthcare Provider Details

I. General information

NPI: 1033032123
Provider Name (Legal Business Name): MACKEY VISION CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 CUMBERLAND FALLS HWY
CORBIN KY
40701-2717
US

IV. Provider business mailing address

PO BOX 880
CORBIN KY
40702-0880
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-1143
  • Fax: 606-523-1145
Mailing address:
  • Phone: 606-528-1143
  • Fax: 606-523-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MR. CLAUDE DAVID ELLIOTT JR.
Title or Position: IT & DATA ANALYST MANAGER
Credential:
Phone: 606-528-1143