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DISTLER HUNTINGTON & BLAIR PSC NPI 1780047456


NPI Information

NPI: 1780047456
Provider Name: DISTLER, HUNTINGTON & BLAIR PSC

Doing Business As: BLUEGRASS EYE CENTER

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 18D2236130

Address:
4402 CHURCHMAN AVE
STE 306
LOUISVILLE, KY
ZIP 40215
Phone: (502) 367-6137
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DISTLER, HUNTINGTON & BLAIR PSC is an ophthalmology in Louisville, KY. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. DISTLER, HUNTINGTON & BLAIR PSC NPI is 1780047456. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Bluegrass Eye Center.

The provider's business location address is:

4402 CHURCHMAN AVE
STE 306
LOUISVILLE, KY
ZIP 40215-101
Phone: (502) 367-6137
Fax: (502) 367-4020

The provider's authorized official is Jennifer Butts .
The authorized official title is Billing Manager and has the following contact phone number (502) 243-2280.

The CLIA number assigned to this NPI record is 18D2236130 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2016 and was last updated on 3/31/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist1994DTKENTUCKYNo
2207W00000XOphthalmology24245KENTUCKYNo
3207W00000XOphthalmology35792KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11177630002MEDICARE NSCKENTUCKY
23822MEDICARE PINKENTUCKY
365917833MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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