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General NPI Number Information
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NPI Number | 1093903619
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Entity Type | Organization
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Legal Business Name | COERS FAMILY EYECARE PC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 2525 CALIFORNIA ST STE G
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City | COLUMBUS
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State | IN
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Zip | 47201-3678
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Country | US
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Telephone | 812-418-0080
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Fax | 812-418-0090
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Provider Business Mailing Address
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Address Line | 2525 CALIFORNIA ST STE G
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City | COLUMBUS
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State | IN
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Zip | 47201-3678
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Country | US
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Telephone | 812-418-0080
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Fax | 812-418-0090
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. BRADFORD R COERS
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Credential | OD
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Telephone | 812-418-0080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18002988B
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License Number State | IN
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