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Organization
COMMONWEALTH EYE CLINIC INC
Active
Organization
COMMONWEALTH EYE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE FERGUSON M.D. (SURGICAL DIRECTOR)
(859) 224-2655
Entity
Organization
Contact information
Practice address
2353 ALEXANDRIA DR, SUITE 325, LEXINGTON, KY 40504-3264
(859) 224-2655
Mailing address
2353 ALEXANDRIA DR, SUITE 325, LEXINGTON, KY 40504-3264
(859) 224-2655
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
300137
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36001121
—
KY
Enumeration date
11/07/2006
Last updated
03/24/2020
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