Healthcare Provider Details

I. General information

NPI: 1295426617
Provider Name (Legal Business Name): KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 BYPASS RD
WINCHESTER KY
40391-2387
US

IV. Provider business mailing address

601 PERIMETER DR
LEXINGTON KY
40517-4121
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-3060
  • Fax: 859-745-0885
Mailing address:
  • Phone: 859-278-9393
  • Fax: 859-278-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMBER WILSON WITT
Title or Position: BILLING MANAGER
Credential:
Phone: 859-278-9393