Healthcare Provider Details

I. General information

NPI: 1851692727
Provider Name (Legal Business Name): LONDON EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 THOMPSON POYNTER RD SUITE 1
LONDON KY
40741-7238
US

IV. Provider business mailing address

PO BOX 310
LONDON KY
40743
US

V. Phone/Fax

Practice location:
  • Phone: 606-878-2012
  • Fax:
Mailing address:
  • Phone: 606-878-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEBRA CROLEY
Title or Position: OWNER
Credential: OD
Phone: 606-878-2012