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Organization
EYE CENTERS OF LOUISVILLE,P.S.C.
Active
Organization
EYE CENTERS OF LOUISVILLE,P.S.C.
Active
Other names
BLUEGRASS SURGERY & LASER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD W BENNETT M.D. (C.E.O.)
(502) 214-3381
Entity
Organization
Contact information
Practice address
1400 POPLAR LEVEL RD, LOUISVILLE, KY 40217-1309
(502) 214-3390
(502) 637-1550
Mailing address
1400 POPLAR LEVEL RD, LOUISVILLE, KY 40217-1309
(502) 214-3390
(502) 637-1550
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300133
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000187473
ANTHEM
KY
05
—
36001071
—
KY
05
—
50002574
—
KY
Enumeration date
07/18/2006
Last updated
08/22/2020
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