Healthcare Provider Details

I. General information

NPI: 1891788402
Provider Name (Legal Business Name): OSSIP OPTOMETRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 OHIO ST
TERRE HAUTE IN
47807-3525
US

IV. Provider business mailing address

9795 CROSSPOINT BLVD STE 100
INDIANAPOLIS IN
46256-3354
US

V. Phone/Fax

Practice location:
  • Phone: 812-232-0073
  • Fax: 812-232-0074
Mailing address:
  • Phone: 317-254-6480
  • Fax: 317-259-8609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. GREGG L OSSIP
Title or Position: OWNER
Credential: OD
Phone: 317-254-6480