Healthcare Provider Details

I. General information

NPI: 1992777031
Provider Name (Legal Business Name): CHRISTINE M VERBECK O. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE M VERBECK O.D.

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S RED BANK RD STE A
EVANSVILLE IN
47712-6509
US

IV. Provider business mailing address

111 S RED BANK RD SUITE B
EVANSVILLE IN
47712-6526
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-4984
  • Fax: 812-423-5029
Mailing address:
  • Phone: 812-423-4984
  • Fax: 812-423-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003218
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: