Organization
CHILDRENS EYE SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARAH S IKRAM M.D. (OPHTHALMOLOGIST)
(502) 425-3148
Entity
Organization
Contact information
Practice address
9700 PARK PLAZA AVE, SUITE 205, LOUISVILLE, KY 40241-2287
(502) 425-3148
(502) 425-3149
Mailing address
9700 PARK PLAZA AVE, SUITE 205, LOUISVILLE, KY 40241-2236
(502) 425-3148
(502) 425-3149
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
33872
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200259330B
—
IN
01
—
50017269
PASSPORT
KY
05
—
6433872600
—
KY
Enumeration date
09/27/2007
Last updated
05/13/2009
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