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General NPI Number Information
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NPI Number | 1194758672
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Entity Type | Organization
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Legal Business Name | MIDWEST GLAUCOMA ASSOCIATES
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 10300 N ILLINOIS ST SUITE 1010
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1164
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Country | US
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Telephone | 317-817-1768
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Fax | 317-817-1777
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Provider Business Mailing Address
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Address Line | 10300 N ILLINOIS ST SUITE 1010
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1164
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Country | US
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Telephone | 317-817-1768
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Fax | 317-817-1777
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. ROBERT MARTIN TROYER
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Credential | M.D.
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Telephone | 317-817-1768
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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 | 50002846A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | IN
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