Organization
BLUEGRASS EYECARE ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES RICHARD BOWERS JR. MD (PRESIDENT)
(859) 278-8443
Entity
Organization
Contact information
Practice address
715 SHAKER DRIVE, SUITE 120, LEXINGTON, KY 40504
(859) 278-8443
(859) 278-6325
Mailing address
715 SHAKER DRIVE, SUITE 120, LEXINGTON, KY 40504
(859) 278-8443
(859) 278-6325
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20668
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051647
BLUE CROSS BLUE SHIELD
KY
01
—
180029936
RAILROAD MEDICARE
KY
05
—
64206683
—
KY
Enumeration date
05/23/2006
Last updated
11/20/2007
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