MEDICARE: LEGACY EYE CENTERS PLLC

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	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1770416109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY EYE CENTERS PLLC

Provider Business Mailing Address
First Line	:	10903 MEETING ST
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-5504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10903 MEETING ST
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-5504
Country	:	US
Telephone Number	:	513-827-0874
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. LAWRENCE ROBERT TENKMAN
Credential	:	MD
Telephone Number	:	513-827-0874

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/13/2026

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Directions to “LEGACY EYE CENTERS PLLC ” Practice Location

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