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General NPI Number Information
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NPI Number | 1568493005
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Entity Type | Organization
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Legal Business Name | WHITSON VISION, PC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 1115 RONALD REAGAN PKWY SUITE 223
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City | AVON
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State | IN
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Zip | 46123-6910
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Country | US
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Telephone | 317-217-3937
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Fax | 317-217-3950
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Provider Business Mailing Address
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Address Line | 901 E 86TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1807
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Country | US
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Telephone | 317-844-5500
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Fax | 317-573-4230
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM E WHITSON
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Credential | MD
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Telephone | 317-844-5500
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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 | 18002221A
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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 | 01036301A
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License Number State | IN
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