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General NPI Number Information
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NPI Number | 1831846369
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC SURGERY CENTER, LLC
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 100 DIAGNOSTIC DR STE B
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City | FRANKFORT
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State | KY
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Zip | 40601-6524
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Country | US
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Telephone | 502-875-9860
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Fax |
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Provider Business Mailing Address
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Address Line | 100 DIAGNOSTIC DR
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City | FRANKFORT
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State | KY
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Zip | 40601-6524
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Country | US
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Telephone | 502-875-9860
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IRFAN ANSARI
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Credential | M.D
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Telephone | 502-682-7845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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