Organization
DISTLER, HUNTINGTON & BLAIR PSC
Active
Other names
Bluegrass Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BUTTS (BILLING MANAGER)
(502) 243-2280
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, STE 306, LOUISVILLE, KY 40215-3101
(502) 367-6137
(502) 367-4020
Mailing address
6400 WESTWIND WAY, CRESTWOOD, KY 40014-6773
(502) 243-2227
(502) 243-2237
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1994DT
KY
207W00000X
Ophthalmology Physician
24245
KY
207W00000X
Ophthalmology Physician
Primary
35792
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65917833
—
KY
Enumeration date
03/31/2016
Last updated
03/31/2016
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