Organization
JOHN KENYON EYE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLEY RENEE GAST (CONTROLLER)
(812) 258-3026
Entity
Organization
Contact information
Practice address
1305 WALL ST, JEFFERSONVILLE, IN 47130-3853
(812) 288-9011
(812) 288-7479
Mailing address
1305 WALL ST, JEFFERSONVILLE, IN 47130-3853
(812) 288-9011
(812) 288-7479
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01025213
IN
207W00000X
Ophthalmology Physician
15811
KY
Other
Enumeration date
08/09/2005
Last updated
08/22/2020
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