| |
200 North Tillotson Avenue, Muncie, IN 47304 | |
(765) 286-8888 | |
(765) 747-7962 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 200 North Tillotson Avenue, Muncie, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255322939 | NPI | - | NPPES |
1072002 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 472, Muncie, IN 47308-0472 Ph: (765) 286-8888 | 200 North Tillotson Avenue, Muncie, IN 47304 Ph: (765) 286-8888 |