Healthcare Provider Details

I. General information

NPI: 1396733390
Provider Name (Legal Business Name): TALLEY CATARACT AND LASER INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W IOWA ST
EVANSVILLE IN
47710-1721
US

IV. Provider business mailing address

220 E VIRGINIA ST
EVANSVILLE IN
47711-5530
US

V. Phone/Fax

Practice location:
  • Phone: 812-424-2020
  • Fax: 812-424-3000
Mailing address:
  • Phone: 812-435-1600
  • Fax: 812-435-1603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. TERRY W TALLEY
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 812-435-1600