Organization
KENTUCKY EYE SURGERY ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RISHI V KUMAR MD (OWNER PRESIDENT)
(502) 368-3937
Entity
Organization
Contact information
Practice address
4940 HAZELWOOD AVENUE, LOUISVILLE, KY 40214
(502) 368-3937
(502) 368-0231
Mailing address
4940 HAZELWOOD AVENUE, LOUISVILLE, KY 40214
(502) 368-3937
(502) 368-0231
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
18740
KY
207W00000X
Ophthalmology Physician
39832
KY
207W00000X
Ophthalmology Physician
40981
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051615
PASSPORT
KY
05
—
64187404
—
KY
01
—
CM8145
RAIL ROAD MEDICARE
KY
Enumeration date
07/03/2007
Last updated
09/05/2023
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