| |
2045 Virginia Ave, Connersville, IN 47331-2921 | |
(765) 825-0660 | |
(765) 825-3075 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 2045 Virginia Ave, Connersville, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356332191 | NPI | - | NPPES |
2086255 | Medicaid | OH | |
100256600B | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 457, Richmond, IN 47375-0457 Ph: (765) 825-0660 | 2045 Virginia Ave, Connersville, IN 47331-2921 Ph: (765) 825-0660 |