Healthcare Provider Details

I. General information

NPI: 1295798809
Provider Name (Legal Business Name): MIDWEST EYE CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAPITAL DR
WARSAW IN
46582-6704
US

IV. Provider business mailing address

PO BOX 549
WABASH IN
46992-0549
US

V. Phone/Fax

Practice location:
  • Phone: 574-269-1331
  • Fax: 574-269-6210
Mailing address:
  • Phone: 260-569-9550
  • Fax: 260-569-9244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number56000164A
License Number StateIN

VIII. Authorized Official

Name: GREGORY L GARNER
Title or Position: PRES./CEO
Credential: OD
Phone: 260-569-9550