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General NPI Number Information
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NPI Number | 1962615419
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Entity Type | Organization
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Legal Business Name | THE EYE CENTER OF LEXINGTON, PLLC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 TAYLORSVILLE RD SUITE A
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City | SHELBYVILLE
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State | KY
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Zip | 40065-8104
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Country | US
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Telephone | 502-633-7310
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Fax | 502-633-0367
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Provider Business Mailing Address
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Address Line | 500 TAYLORSVILLE RD SUITE A
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City | SHELBYVILLE
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State | KY
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Zip | 40065-8104
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Country | US
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Telephone | 502-633-7310
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Fax | 502-633-0367
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Authorized Official
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Title or Position | MEMBER
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Name | DR. TIMOTHY ALAN PARKER
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Credential | OD
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Telephone | 502-633-7310
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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 | 1572DT
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License Number State | KY
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