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General NPI Number Information
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NPI Number | 1083940936
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Entity Type | Organization
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Legal Business Name | RETINA CONSULTANTS OF INDIANA & OHIO, PC.
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 2302 CHESTER BLVD
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City | RICHMOND
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State | IN
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Zip | 47374-1221
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Country | US
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Telephone | 765-213-3238
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Fax | 765-284-2434
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Provider Business Mailing Address
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Address Line | PO BOX 112
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City | MUNCIE
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State | IN
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Zip | 47308-0112
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Country | US
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Telephone | 765-213-3238
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Fax | 765-284-2434
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Authorized Official
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Title or Position | OWNER/ PHYSICIAN
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Name | JEFFREY S RAPKIN
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Credential |
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Telephone | 765-759-0177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 01045320
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License Number State | IN
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