MEDICARE: OSSIP OPTOMETRY, P.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023031416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSSIP OPTOMETRY, P.C

Provider Business Mailing Address
First Line	:	9795 CROSSPOINT BLVD
Second Line	:	STE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3354
Country	:	US
Telephone Number	:	317-254-6480
Fax Number	:	317-259-8609

Provider Business Practice Location Address
First Line	:	1919 E MARKLAND AVE
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46901-6237
Country	:	US
Telephone Number	:	765-459-5545
Fax Number	:	765-459-5550

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GREGG L OSSIP
Credential	:	OD
Telephone Number	:	317-254-6480

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	10/13/2015

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Directions to “OSSIP OPTOMETRY, P.C ” Practice Location

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