Northwest Indiana Eye & Laser Center Pc | |
851 Eastport Centre Dr, Valparaiso, IN 46383-2909 | |
(219) 464-8223 | |
(219) 531-2356 |
Full Name | Northwest Indiana Eye & Laser Center Pc |
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Type | Facility |
Speciality | Ophthalmology |
Location | 851 Eastport Centre Dr, Valparaiso, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336212117 | NPI | - | NPPES |
200343240A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Gregory S Densborn |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164451167 PECOS PAC ID: 6002719135 Enrollment ID: I20040128000266 |
Provider Name | Richard S Carlson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073515938 PECOS PAC ID: 2769566322 Enrollment ID: I20080221000281 |
Provider Name | Scott Allen Buck |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1801856943 PECOS PAC ID: 4789660937 Enrollment ID: I20080429000368 |
Provider Name | Stephen R Buck |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1134235849 PECOS PAC ID: 0345226593 Enrollment ID: I20080429000485 |
Provider Name | Ricky L Weidow |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639177793 PECOS PAC ID: 8921022328 Enrollment ID: I20091223000119 |
Provider Name | David F Ryser |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1528061363 PECOS PAC ID: 6507963329 Enrollment ID: I20100305000665 |
Provider Name | Ellyn M Lovett |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1558468447 PECOS PAC ID: 6002214418 Enrollment ID: I20211014001764 |
Mailing Address | Practice Location Address |
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Northwest Indiana Eye & Laser Center Pc 851 Eastport Centre Dr, Valparaiso, IN 46383-2909 Ph: (219) 464-8223 | Northwest Indiana Eye & Laser Center Pc 851 Eastport Centre Dr, Valparaiso, IN 46383-2909 Ph: (219) 464-8223 |