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General NPI Number Information
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NPI Number | 1477903789
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Entity Type | Organization
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Legal Business Name | LAI VISION AND SURGERY, LLC
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 10300 N ILLINOIS ST STE 1000
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City | CARMEL
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State | IN
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Zip | 46290-1167
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Country | US
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Telephone | 317-805-2240
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Fax | 317-527-4708
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Provider Business Mailing Address
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Address Line | 10300 N ILLINOIS ST STE 1000
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City | CARMEL
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State | IN
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Zip | 46290-1167
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Country | US
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Telephone | 317-805-2240
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Fax | 317-527-4708
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. KEVIN E LAI
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Credential | M.D.
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Telephone | 918-808-3433
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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 | 01074332A
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License Number State | IN
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