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General NPI Number Information
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NPI Number | 1750662979
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Entity Type | Organization
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Legal Business Name | OSSIP OPTOMETRY, P.C.
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 5606 E WASHINGTON ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-6428
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Country | US
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Telephone | 317-357-8385
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Fax | 317-352-8747
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Provider Business Mailing Address
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Address Line | 9795 CROSSPOINT BLVD STE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-3354
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Country | US
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Telephone | 317-254-6480
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Fax | 317-259-8609
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Authorized Official
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Title or Position | OWNER
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Name | MR. GREGG L OSSIP
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Credential | OD
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Telephone | 317-254-6480
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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 | 18001588
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License Number State | IN
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