Organization
EYE PHYSICIANS OF ELIZABETHTOWN PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKY WOODS (BILLING MANAGER)
(270) 765-6066
Entity
Organization
Contact information
Practice address
1109 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 765-6066
(270) 737-2354
Mailing address
1109 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 765-6066
(270) 737-2354
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65924607
—
KY
Enumeration date
10/12/2005
Last updated
06/13/2016
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