Healthcare Provider Details

I. General information

NPI: 1609958081
Provider Name (Legal Business Name): FISCHER EYECARE SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 MEDICAL PL
SEYMOUR IN
47274-2639
US

IV. Provider business mailing address

1125 MEDICAL PL
SEYMOUR IN
47274-2639
US

V. Phone/Fax

Practice location:
  • Phone: 812-522-1800
  • Fax: 812-522-6932
Mailing address:
  • Phone: 812-522-1800
  • Fax: 812-522-6932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18002246B
License Number StateIN

VIII. Authorized Official

Name: LINDA L. FISCHER
Title or Position: PRESIDENT
Credential:
Phone: 812-522-1800