Healthcare Provider Details

I. General information

NPI: 1417014705
Provider Name (Legal Business Name): EYE SPECIALISTS OF LOUISVILLE, P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E MUHAMMAD ALI BLVD
LOUISVILLE KY
40202-1511
US

IV. Provider business mailing address

301 E MUHAMMAD ALI BLVD
LOUISVILLE KY
40202-1511
US

V. Phone/Fax

Practice location:
  • Phone: 502-852-5466
  • Fax: 502-852-4947
Mailing address:
  • Phone: 502-852-2889
  • Fax: 502-852-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY J KAPLAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 502-852-5466