Organization
TRI-STATE DOCTORS OF
Active
Other names
KY Doctors of Optometry, Visionworks Doctors of Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT RUBESH O.D. (OWNER)
(270) 750-8384
Entity
Organization
Contact information
Practice address
4655 OUTER LOOP, LOUISVILLE, KY 40219-3970
(502) 966-2020
(502) 966-2099
Mailing address
PO BOX 846027, DALLAS, TX 75284-6027
(726) 444-4069
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7790293000
—
KY
Enumeration date
10/25/2006
Last updated
09/21/2023
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