| Oak Tree Eye Clinic Inc Psc | |
|
1601 West Everly Brothers Blvd, Central City, KY 42330-0676 | |
| (270) 754-4515 | |
| (270) 754-2547 |
| Full Name | Oak Tree Eye Clinic Inc Psc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1601 West Everly Brothers Blvd, Central City, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821089640 | NPI | - | NPPES |
| 77903906 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
| Provider Name | Tyler Neal Mayes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053609420 PECOS PAC ID: 1456522481 Enrollment ID: I20110922000312 |
| Provider Name | Jesse E Boles |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487223806 PECOS PAC ID: 0840698858 Enrollment ID: I20211005003425 |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Tree Eye Clinic Inc Psc 1601 West Everly Brothers Blvd, Central City, KY 42330-0676 Ph: (270) 754-4515 | Oak Tree Eye Clinic Inc Psc 1601 West Everly Brothers Blvd, Central City, KY 42330-0676 Ph: (270) 754-4515 |
Dr. Michael R Braden, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 1725 W Everly Brothers Blvd, Central City, KY 42330 Phone: 270-754-4483 Fax: 270-754-4909 | |
Tyler Neal Mayes, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1601 W Everly Brothers Blvd, Central City, KY 42330 Phone: 270-754-4515 Fax: 270-754-2547 | |
Dr. Freddie Michael Mayes, OD OPTOMETRIST Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1601 West Everly Brothers Blvd, Central City, KY 42330 Phone: 270-754-4515 Fax: 270-754-2547 |