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General NPI Number Information
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NPI Number | 1356639843
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Entity Type | Organization
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Legal Business Name | KEEN EYECARE CONSULTANTS INC.
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 6436 E. FLORIDA STREET SUITE 102
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City | EVANSVILLE
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State | IN
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Zip | 47715
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Country | US
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Telephone | 812-200-8112
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Fax | 812-200-2823
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Provider Business Mailing Address
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Address Line | PO BOX 8115
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City | EVANSVILLE
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State | IN
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Zip | 47716-8115
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Country | US
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Telephone | 812-200-8112
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Fax | 812-200-2823
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACOB F SCHMITT
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Credential | OD
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Telephone | 812-200-8112
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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 | 18003677A
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License Number State | IN
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