1518572957 NPI number — KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY

Table of content: MARTA CACERES DAHIYA M.D. (NPI 1962474403)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518572957 NPI number — KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KENTUCKY INSTITUTE FOR EYE HEALTH & SURGERY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518572957
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 PERIMETER DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40517-4121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-278-9393
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 FRANKFORT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERSAILLES
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40383-1121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-873-7805
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2020

Additional Information

Authorized Official

Authorized Official Last Name:
DOOLIN
Authorized Official First Name:
SHERRI
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
BILLING MANAGER/AM
Authorized Official Telephone Number:
859-278-9393

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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