Healthcare Provider Details

I. General information

NPI: 1699950592
Provider Name (Legal Business Name): MICHAEL GETTELFINGER OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 STATE ST
NEW ALBANY IN
47150-4911
US

IV. Provider business mailing address

1501 STATE ST
NEW ALBANY IN
47150-4911
US

V. Phone/Fax

Practice location:
  • Phone: 812-945-1162
  • Fax: 812-945-5592
Mailing address:
  • Phone: 812-945-1162
  • Fax: 812-945-5592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number18001831A
License Number StateIN

VIII. Authorized Official

Name: JANET GETTELFINGER
Title or Position: OFFICE MANAGER
Credential:
Phone: 812-945-1162