Healthcare Provider Details

I. General information

NPI: 1811034259
Provider Name (Legal Business Name): BROWNSBURG FAMILY EYECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HORNADAY ROAD
BROWNSBURG IN
46112-0809
US

IV. Provider business mailing address

90 HORNADAY ROAD
BROWNSBURG IN
46112-0809
US

V. Phone/Fax

Practice location:
  • Phone: 317-852-4741
  • Fax: 317-858-2967
Mailing address:
  • Phone: 317-852-4741
  • Fax: 317-858-2967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18001609B
License Number StateIN

VIII. Authorized Official

Name: RICHARD M HOFFMAN
Title or Position: PRESIDENT
Credential: O.D.
Phone: 317-852-4741