Healthcare Provider Details

I. General information

NPI: 1164493011
Provider Name (Legal Business Name): THEODORE JERE STRANSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W COLUMBIA ST SUITE 250
EVANSVILLE IN
47710-1782
US

IV. Provider business mailing address

10111 POWERS DR
NEWBURGH IN
47630-9213
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-3161
  • Fax:
Mailing address:
  • Phone: 812-853-6889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number01027485
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: