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NPI Code Detail

MEDICARE: OSSIP OPTOMETRY, PC

MEDICARE: OSSIP OPTOMETRY, PC
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
1152W00000XOptometristIN

General Provider Information

NPI Number : 1205233491
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSSIP OPTOMETRY, PC
Provider Business Mailing Address
First Line : 9795 CROSSPOINT BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3354
Country : US
Telephone Number : 317-254-6480
Fax Number :
Provider Business Practice Location Address
First Line : 3401 LAKE AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-5500
Country : US
Telephone Number : 260-426-3095
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF FINANCE AND INSURANCE
Name : RYAN DABELOW
Credential :
Telephone Number : 317-254-6480
Provider Enumeration Date : 12/03/2014
Last Update Date : 12/03/2014

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Directions to “OSSIP OPTOMETRY, PC ” Practice Location

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