Organization
ELITE VISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE MATTHEW BARNES O.D. (MEMBER/OWNER)
(606) 248-2549
Entity
Organization
Contact information
Practice address
1403 CUMBERLAND AVE, SUITE A, MIDDLESBORO, KY 40965-1158
(606) 248-2549
(606) 248-9188
Mailing address
1403 CUMBERLAND AVE, SUITE A, MIDDLESBORO, KY 40965-1158
(606) 248-2549
(606) 248-9188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KY 1711
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1526915
—
TN
05
—
7100202310
—
KY
Enumeration date
02/13/2012
Last updated
08/16/2012
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