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General NPI Number Information
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NPI Number | 1588192157
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Entity Type | Organization
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Legal Business Name | PANKRATZ MEDICAL LLC
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 3135 MIDDLE DR
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City | COLUMBUS
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State | IN
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Zip | 47203-4472
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Country | US
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Telephone | 812-373-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 401 COMMERCE ST STE 600
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City | NASHVILLE
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State | TN
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Zip | 37219-2518
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Country | US
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Telephone | 615-345-6900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL J PANKRATZ
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Credential |
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Telephone | 812-373-7777
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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 |
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License Number State |
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