Healthcare Provider Details

I. General information

NPI: 1659385508
Provider Name (Legal Business Name): EYE CENTERS OF LOUISVILLE,PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 BLUEGRASS AVE STE 200
LOUISVILLE KY
40215-1181
US

IV. Provider business mailing address

PO BOX 736502
CHICAGO IL
60673-6502
US

V. Phone/Fax

Practice location:
  • Phone: 502-895-0040
  • Fax: 502-361-4488
Mailing address:
  • Phone: 502-895-0040
  • Fax: 502-361-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: JOSEPH P GIRA
Title or Position: OWNER
Credential: M.D.
Phone: 314-909-0633