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General NPI Number Information
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NPI Number | 1801106778
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Entity Type | Organization
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Legal Business Name | MILES EYE CARE, PC
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 415 METRO AVE
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City | EVANSVILLE
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State | IN
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Zip | 47715-2805
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Country | US
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Telephone | 812-476-2000
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Fax | 812-477-1533
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Provider Business Mailing Address
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Address Line | 415 METRO AVE
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City | EVANSVILLE
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State | IN
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Zip | 47715-2805
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Country | US
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Telephone | 812-476-2000
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Fax | 812-477-1533
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JOHN D MILES
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Credential | O.D.
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Telephone | 812-476-2000
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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 | 18002272A
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License Number State | IN
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