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Organization

ASSOCIATES IN EYE CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY WALTER UPCHURCH OD (PRESIDENT AND AUTHORIZED OFFICIAL)
(606) 387-5612
Entity
Organization

Contact information

Practice address
127 FOOTHILLS AVE, SUITE 3, ALBANY, KY 42602-1090
(606) 387-5612
(606) 387-6602
Mailing address
PO BOX 306, FERGUSON, KY 42533-0306
(606) 492-2211
(606) 676-0873

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0096602
MEDICARE # FOR DR. GARY UPCHURCH
LA
01
0096603
MEDICARE # FOR DR. MARK JACOBS
KY
05
1511738
TN
01
39973; 4209301
BCBSTN/BLUECARE/TENNCARE
TN
01
46411
OPTUMHEALTH VISION
01
7100184290
MEDICAID # FOR DR. BENJAMIN BRENNER
KY
05
7100209970
KY
01
77009298
MEDICAID # FOR DR. GARY UPCHURCH
KY
01
77012011
MEDICAID # FOR DR. MARK JACOBS
KY
05
77900520
KY
01
CB8623
RAILROAD MEDICARE
KY
01
CP0230:013
EYEMED
01
K009923
MEDICARE PTAN # FOR DR. BRENNER
KY
Enumeration date
08/31/2006
Last updated
03/22/2021
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