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
1	152W00000X	Optometrist	18003257	IN

General Provider Information

NPI Number	:	1902943376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSSIP OPTOMETRY PC

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	:	2902 W 86TH ST
Second Line	:	STE 160
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2196
Country	:	US
Telephone Number	:	317-337-1233
Fax Number	:	317-337-1225

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	10/09/2014

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Directions to “OSSIP OPTOMETRY PC ” Practice Location

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