Retina Associates, Psc

NPI #1285639666 in Louisville, Kentucky

Provider Information

NPI Number: 1285639666
Entity Type: Organization
Organization Name: Retina Associates, Psc
Primary Specialty: Ophthalmology
Enumeration Date: Jun 14, 2005
Last Updated: Oct 15, 2018

Practice Location

Address: 1536 STORY AVE
Address 2: THE EYE CARE INSTITUTE BUILDING
City: Louisville
State: Kentucky
ZIP Code: 40206-1738
Phone: (502) 589-1500

Authorized Official

Name: MR. MARK M PRUSSIAN, MBA, FACHE, COE
Title: ADMINISTRATOR
Phone: (502) 589-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary
Optometrist	152W00000X

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