Healthcare Provider Details

I. General information

NPI: 1184458432
Provider Name (Legal Business Name): WAHL TO WAHL EYECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11594 WHISTLE DR STE 170
FISHERS IN
46037-0054
US

IV. Provider business mailing address

9933 TIMBERWOOD LN
MCCORDSVILLE IN
46055-7207
US

V. Phone/Fax

Practice location:
  • Phone: 317-360-1101
  • Fax: 317-360-8160
Mailing address:
  • Phone: 812-498-2817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. NOAH THOMAS WAHL
Title or Position: OWNER
Credential: OD
Phone: 812-498-2817