Healthcare Provider Details

I. General information

NPI: 1275946972
Provider Name (Legal Business Name): EMMICK EYE CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 EASTWIND CT
HAWESVILLE KY
42348-6736
US

IV. Provider business mailing address

123 EASTWIND CT
HAWESVILLE KY
42348-6736
US

V. Phone/Fax

Practice location:
  • Phone: 270-927-8700
  • Fax: 270-927-0837
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1919DT
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1064DT
License Number StateKY

VIII. Authorized Official

Name: MARY E EMMICK MORRIS
Title or Position: MEMBER
Credential: O.D.
Phone: 270-927-8700