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Organization
PADUCAH OPHTHALMOLOGY ASC LLC
Active
Organization
PADUCAH OPHTHALMOLOGY ASC LLC
Active
Other names
The Eye Surgery Center of Paducah
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
100 MEDICAL CENTER DR, PADUCAH, KY 42003-7909
(270) 442-1024
(270) 442-1001
Mailing address
1A BURTON HILLS BLVD, ATTN: L&C, NASHVILLE, TN 37215-6103
(270) 442-1024
(270) 442-1001
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300083
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000231770
ANTHEM BLUE CROSS BLUE SH
KY
05
—
36001212
—
KY
Enumeration date
02/10/2006
Last updated
05/03/2022
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