Organization
OAK TREE EYE CLINIC INC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDDIE M MAYES (PRESIDENT)
(270) 754-4515
Entity
Organization
Contact information
Practice address
1601 WEST EVERLY BROTHERS BLVD, CENTRAL CITY, KY 42330-0676
(270) 754-4515
(270) 754-2547
Mailing address
1601 WEST EVERLY BROTHERS BLVD, CENTRAL CITY, KY 42330-0676
(270) 754-4515
(270) 754-2547
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77903906
—
KY
Enumeration date
11/01/2005
Last updated
06/25/2010
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