Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
Norton Children's Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GAST (SYST VP MNGD CARE & PAYOR STRAT)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 272-5134
(502) 272-5339
Mailing address
PO BOX 776879, CHICAGO, IL 60677
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
05/28/2020
Last updated
09/22/2021
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