MEDICARE: TALLEY MEDICAL-SURGICAL EYE CARE ASSOCIATES 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		IN
2	207W00000X	Ophthalmology Physician

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154319143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALLEY MEDICAL-SURGICAL EYE CARE ASSOCIATES PC

Provider Business Mailing Address
First Line	:	6149 E COLUMBIA ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-9134
Country	:	US
Telephone Number	:	812-424-2020
Fax Number	:	812-424-3000

Provider Business Practice Location Address
First Line	:	6149 E COLUMBIA ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715
Country	:	US
Telephone Number	:	812-424-2020
Fax Number	:	812-424-3000

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. DREW N. SOMMERVILLE
Credential	:	M.D.
Telephone Number	:	812-424-2020

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	11/20/2025

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