Provider Demographics
NPI:1396475042
Name:NORDIN EYE CENTER, PSC
Entity type:Organization
Organization Name:NORDIN EYE CENTER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:STAMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-788-0433
Mailing Address - Street 1:917 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-1407
Mailing Address - Country:US
Mailing Address - Phone:606-788-0433
Mailing Address - Fax:
Practice Address - Street 1:100 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-229-8555
Practice Address - Fax:606-789-5053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORDIN EYE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-15
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty