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General NPI Number Information
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NPI Number | 1457763948
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Entity Type | Organization
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Legal Business Name | WEBB FAMILY EYECARE PLC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 4216 SUMMIT PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40241-8106
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Country | US
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Telephone | 502-599-4196
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Fax | 502-327-5129
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Provider Business Mailing Address
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Address Line | 4216 SUMMIT PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40241-8106
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Country | US
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Telephone | 502-599-4196
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Fax | 502-327-5129
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY E WEBB
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Credential | OD
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Telephone | 502-599-4196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1236DT
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License Number State | KY
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