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General NPI Number Information
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NPI Number | 1174566921
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Entity Type | Organization
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Legal Business Name | INDIANA UNIVERSITY
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 744 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47405-3603
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Country | US
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Telephone | 812-855-8436
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Fax | 812-856-1683
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Provider Business Mailing Address
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Address Line | 744 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47405-3603
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Country | US
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Telephone | 812-855-8436
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Fax | 812-856-1683
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Authorized Official
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Title or Position | BUSINESS MGR
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Name | JENNIFER S FISHER
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Credential |
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Telephone | 812-856-3624
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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 |
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License Number State |
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