| NPI | 1033285960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE STIVERS President 502-226-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 14531) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 00001064) |
| 207W00000X Ophthalmology (Licence: KY 38681) | |
| 208000000X Pediatrics (Licence: AL 00021495) | |
| 208000000X Pediatrics (Licence: KY 39146) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2011-09-28 |