Healthcare Provider Details

I. General information

NPI: 1336257542
Provider Name (Legal Business Name): INDIANAPOLIS OPHTHALMOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 CITY CENTER DR STE 150
CARMEL IN
46032-3104
US

IV. Provider business mailing address

1320 CITY CENTER DR STE 150
CARMEL IN
46032-3104
US

V. Phone/Fax

Practice location:
  • Phone: 317-846-4223
  • Fax: 317-846-6063
Mailing address:
  • Phone: 317-846-4223
  • Fax: 317-846-6063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHLEEN A DILTS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 317-819-0742