Organization
JACOB FAMILY EYECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN SEAN JACOB O.D. (OWNER/OPTOMETRIST)
(859) 824-1333
Entity
Organization
Contact information
Practice address
20 FERGUSON BLVD, DRY RIDGE, KY 41035-8635
(859) 824-1333
(859) 824-1300
Mailing address
20 FERGUSON BLVD, DRY RIDGE, KY 41035-8635
(859) 824-1333
(859) 824-1300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1452DT
KY
152W00000X
Optometrist
Primary
1458DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77001535
—
KY
05
—
77001576
—
KY
Enumeration date
02/17/2015
Last updated
02/17/2015
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