MEDICARE: VISION ONE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	180001	IN
2	152W00000X	Optometrist	180025	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073687604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION ONE PC

Provider Business Mailing Address
First Line	:	1538 119TH ST
Second Line	:
City	:	WHITING
State	:	IN
Zip	:	46394-1733
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1538 119TH ST
Second Line	:
City	:	WHITING
State	:	IN
Zip	:	46394-1733
Country	:	US
Telephone Number	:	219-659-0805
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PAUL CUROSH
Credential	:
Telephone Number	:	219-322-4348

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	03/07/2014

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Directions to “VISION ONE PC ” Practice Location

Language	Start Address	Practice Location

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