| |
1160 W. Michigan St., Indianapolis, IN 46202-5209 | |
(317) 274-2020 | |
(317) 274-3265 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1160 W. Michigan St., Indianapolis, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548261894 | NPI | - | NPPES |
100067460 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (Indiana) | Primary |
Mailing Address | Practice Location Address |
---|---|
1160 W. Michigan St., Indianapolis, IN 46202-5209 Ph: (317) 274-2020 | 1160 W. Michigan St., Indianapolis, IN 46202-5209 Ph: (317) 274-2020 |