| |
1101 O'connor Blvd, Monticello, IN 47960 | |
(574) 583-7111 | |
(574) 583-1715 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1101 O'connor Blvd, Monticello, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528040516 | NPI | - | NPPES |
100339260P | 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 472, Muncie, IN 47308-0472 Ph: (765) 286-8888 | 1101 O'connor Blvd, Monticello, IN 47960 Ph: (574) 583-7111 |