Organization
DERBY CITY EYE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY D. FOWLER O.D. (OWNER)
(502) 996-7450
Entity
Organization
Contact information
Practice address
6501 VETERANS MEMORIAL PKWY, CRESTWOOD, KY 40014-8694
(502) 996-7450
(844) 270-4014
Mailing address
6501 VETERANS MEMORIAL PKWY, CRESTWOOD, KY 40014-8694
(502) 996-7450
(844) 270-4014
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1811DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100428530
—
KY
Enumeration date
01/22/2016
Last updated
03/17/2018
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