Healthcare Provider Details

I. General information

NPI: 1871588442
Provider Name (Legal Business Name): 20/20 EYE PHYSICIANS OF INDIANA P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 NAAB RD STE 200
INDIANAPOLIS IN
46260-1933
US

IV. Provider business mailing address

8220 NAAB RD STE 200
INDIANAPOLIS IN
46260-1933
US

V. Phone/Fax

Practice location:
  • Phone: 317-817-5900
  • Fax:
Mailing address:
  • Phone: 317-871-5900
  • Fax: 317-872-6439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA M IRELAND
Title or Position: PRACTICE MANAGER
Credential: COA
Phone: 317-871-5900