Basic Information
| Provider Information | |||||||||
| NPI: | 1154854990 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WELDY | ||||||||
| FirstName: | ERIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 N EAGLE CREEK DR STE 500 | ||||||||
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| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405091802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592633900 | ||||||||
| FaxNumber: | 8592633757 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 CONN TER | ||||||||
| Address2: | STE 550 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593235867 | ||||||||
| FaxNumber: | 8593238510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2017 | ||||||||
| LastUpdateDate: | 06/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207W00000X | TP035 | KY | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 55414 | KY | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.