# MAR-TAN FAMILY VISION CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033110291
- **Authorized official:** MR. JIMMIE T PHELPS (OWNER / OPTICIAN)
- **Authorized official phone:** (859) 623-4267

## Contact information

- **Practice address:** 205 GERI LN, RICHMOND, KY 40475-2359
- **Practice address phone:** (859) 623-4267
- **Practice address fax:** (859) 623-4249
- **Mailing address:** 205 GERI LN, RICHMOND, KY 40475-2359
- **Mailing address phone:** (859) 623-4267
- **Mailing address fax:** (859) 623-4249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | KY325 | KY | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 12/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000195501 | ANTHEM | KY |
| 01 | — | 1141 | PVC | KY |
| 01 | — | 1188575 | CHA | KY |
| 01 | — | 2537729 | CIGNA | KY |
| 01 | — | 260155886 | TRICARE | KY |
| 01 | — | 32646 | CVC | KY |
| 05 | — | 52800919 | — | KY |
| 05 | — | 52903259 | — | KY |
| 01 | — | OP0933 | EYEMED | KY |