Healthcare Provider Details
I. General information
NPI: 1598563314
Provider Name (Legal Business Name): FLYING EYE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
112 S VINSON AVE
LOUISA KY
41230-1155
US
IV. Provider business mailing address
1401 HARRODSBURG RD STE B290
LEXINGTON KY
40504-1730
US
V. Phone/Fax
- Phone: 859-277-2692
- Fax: 859-277-9275
- Phone: 859-277-2692
- Fax: 859-277-9275
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERRI
ANN
DOOLIN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 859-338-8590