Healthcare Provider Details

I. General information

NPI: 1598812562
Provider Name (Legal Business Name): ROBERT W. SEAY II O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 LAFAYETTE RD
INDIANAPOLIS IN
46222-2147
US

IV. Provider business mailing address

12276 WESTMORLAND DR
FISHERS IN
46037-4406
US

V. Phone/Fax

Practice location:
  • Phone: 317-924-1300
  • Fax:
Mailing address:
  • Phone: 317-924-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18002184
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number18002184
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number18002184
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number18002184
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: