Healthcare Provider Details
I. General information
NPI: 1285689166
Provider Name (Legal Business Name): EYE HEALTH SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
165 PARKERS MILL WAY
SOMERSET KY
42503-4151
US
IV. Provider business mailing address
2835 S HIGHWAY 27 STE 196
SOMERSET KY
42501-3042
US
V. Phone/Fax
- Phone: 606-677-0377
- Fax: 606-677-6542
- Phone: 606-677-0377
- Fax: 606-677-6542
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WV0400X |
| Taxonomy | Vision Therapy Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TAMELA
MARIE
BROWN-MURRAY
Title or Position: OWNER/OPTOMETRIST
Credential: O. D.
Phone: 606-677-0377