MEDICARE: THE EYE ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist
2	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1316013691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE EYE ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	2620 S EAGLE RD
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6704
Country	:	US
Telephone Number	:	208-342-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 S EAGLE RD
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6704
Country	:	US
Telephone Number	:	208-342-5151
Fax Number	:

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. GREGORY J KENT
Credential	:	M.D
Telephone Number	:	208-342-5151

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	04/18/2024

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