Provider Demographics
NPI:1730373044
Name:ABNEY EYE CENTER, PLLC
Entity type:Organization
Organization Name:ABNEY EYE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-259-0500
Mailing Address - Street 1:31 BOBBY BLAND WAY
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-0000
Mailing Address - Country:US
Mailing Address - Phone:270-259-0500
Mailing Address - Fax:
Practice Address - Street 1:31 BOBBY BLAND WAY
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-1744
Practice Address - Country:US
Practice Address - Phone:270-259-0500
Practice Address - Fax:270-259-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY1450DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77000065Medicaid
KY77000065Medicaid
5984000001Medicare NSC