Healthcare Provider Details

I. General information

NPI: 1073513412
Provider Name (Legal Business Name): CHRISTOPHER J KUC OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2353 ALEXANDRIA DR STE 260
LEXINGTON KY
40504-3208
US

IV. Provider business mailing address

2353 ALEXANDRIA DR STE 350
LEXINGTON KY
40504-3208
US

V. Phone/Fax

Practice location:
  • Phone: 859-224-2655
  • Fax: 859-223-7147
Mailing address:
  • Phone: 859-224-2655
  • Fax: 859-223-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2463DT
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG001266
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: