MEDICARE: DR. STEVEN CHARLES MATHER OD

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	18001998B	IN

General Provider Information

NPI Number	:	1629047923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN CHARLES MATHER OD

Provider Business Mailing Address
First Line	:	1401 UNION ST
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-2059
Country	:	US
Telephone Number	:	765-742-1955
Fax Number	:	765-742-2020

Provider Business Practice Location Address
First Line	:	1401 UNION ST
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-2059
Country	:	US
Telephone Number	:	765-742-1955
Fax Number	:	765-742-2020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. STEVEN CHARLES MATHER OD” Practice Location

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