| NPI | 1073951356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW STIVERS President 502-229-1744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 40801) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 43264) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |