| Allisonville Eye Care Center, Inc | |
|
10967 Allisonville Rd Suite 120 Fishers IN 46038-2632 | |
| (317) 577-0707 | |
| (317) 577-1567 |
| Full Name | Allisonville Eye Care Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10967 Allisonville Rd, Fishers, Indiana |
| Authorized Official Name and Position | Mark William Roark (PRESIDENT) |
| Authorized Official Contact | 3175770707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allisonville Eye Care Center, Inc 10967 Allisonville Rd Suite 120 Fishers IN 46038-2632 Ph: (317) 577-0707 | Allisonville Eye Care Center, Inc 10967 Allisonville Rd Suite 120 Fishers IN 46038-2632 Ph: (317) 577-0707 |
| NPI Number | 1992830319 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 01/21/2010 |
| Medicare PECOS PAC ID | 8921052903 |
|---|---|
| Medicare Enrollment ID | O20050311000847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992830319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 18002130A (Indiana) | Primary |
| Provider Name | Mark W Roark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598890907 PECOS PAC ID: 5092769075 Enrollment ID: I20050312000060 |
| Provider Name | Kelly Christine Trussell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003291089 PECOS PAC ID: 6800102401 Enrollment ID: I20150827000969 |
| Provider Name | Daniel Bollier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942703210 PECOS PAC ID: 4981969334 Enrollment ID: I20180605003607 |
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