Unknown Individual – Ophthalmology Physician, NPI 1104842517
Ophthalmology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
77, Mack Walters Road, Shelbyville, Shelby County, Kentucky, 40065, United States
SUITE 300
SHELBYVILLE, KY 400651789
Phone: (502) 226-3937
Fax: (502) 633-0387
Type: Location
6625, West Rose Garden Lane, Glendale, Maricopa County, Arizona, 85308, United States
GLENDALE, AZ 853086436
Phone: (623) 572-2997
Fax: (502) 633-0387
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 40065)
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