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Ky Doctors of Optometry, PLLC

Organization Active NPI Eyewear Supplier · Ashland, KY

NPI 1699086629 · NPPES record last updated Sep 11, 2024

Key facts

NPI
1699086629
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
Legal business name
KY DOCTORS OF OPTOMETRY, PLLC
Practice address
500 Winchester Ave
Ste. 810
Ashland, KY 41101-7362
Phone
(606) 324-3672
Fax
(606) 324-4566
NPI assigned
Jun 24, 2010
Organization subpart
No

Authorized official

Name
Grant Rubesh
Title
Owner
Phone
(726) 444-4078

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 65

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ky Doctors of Optometry, PLLC
500 Winchester Ave, Ashland, KY 41101-7362 · (606) 324-3672		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignment
Participating since Oct 1, 1998

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110106001161 KY DME Supplier - Physician - Optometrist 0941108732 Practice locations: Ashland, KY

National Provider Directory

Tax ID family
Dr Mark Lynn and Associat (22 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Yes

Addresses

Primary practice location

500 Winchester Ave
Ste. 810
Ashland, KY 41101-7362

Mailing address

PO Box 846027
Dallas, TX 75284-6027
Phone (210) 524-6663

Other names

  • KY Doctors of Optometry Doing business as
  • Visionworks Doctors of Optometry Doing business as

Other providers in Ashland, KY

All providers in Ashland, KY · Eyewear Supplier in Kentucky

Sources for this page

Verify at the official NPI Registry.