MEDICARE: INDIANAPOLIS OPHTHALMOLOGY 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	332B00000X	Durable Medical Equipment & Medical Supplies	01034454A	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	:	1912011388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIANAPOLIS OPHTHALMOLOGY PC

Provider Business Mailing Address
First Line	:	1320 CITY CENTER DR STE 150
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-3104
Country	:	US
Telephone Number	:	317-846-4223
Fax Number	:	317-846-6063

Provider Business Practice Location Address
First Line	:	3850 SHORE DR STE 100
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5621
Country	:	US
Telephone Number	:	317-293-1420
Fax Number	:	317-297-6507

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MRS. KATHLEEN A DILTS
Credential	:
Telephone Number	:	317-846-4223

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	12/27/2024

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