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NPI Code Detail

MEDICARE: TESSA R. METZING O.D

MEDICARE: TESSA R. METZING O.D
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
1152W00000XOptometrist18003572ABIN

General Provider Information

NPI Number : 1205090750
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA R. METZING O.D
Provider Business Mailing Address
First Line : 900 EDWARDS DR
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-5680
Country : US
Telephone Number : 317-839-2368
Fax Number : 317-839-1267
Provider Business Practice Location Address
First Line : 1855 STAFFORD RD
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-2338
Country : US
Telephone Number : 317-839-2368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2008
Last Update Date : 02/18/2020

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