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General NPI Number Information
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NPI Number | 1528119492
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Entity Type | Organization
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Legal Business Name | ADVANCED VISION ASSOCIATES LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 12/18/2009
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Provider Practice Location Address
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Address Line | 4405 BELLEMEADE AVE STE. 101
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City | EVANSVILLE
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State | IN
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Zip | 47714-0682
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Country | US
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Telephone | 812-474-1010
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Fax | 812-485-2476
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Provider Business Mailing Address
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Address Line | 4405 BELLEMEADE AVE STE. 101
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City | EVANSVILLE
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State | IN
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Zip | 47714-0682
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Country | US
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Telephone | 812-474-1010
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Fax | 812-485-2476
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY M. CROWLEY
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Credential | M.D.
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Telephone | 812-474-1010
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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 | 01029433
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License Number State | IN
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