INDIANA RETINA CENTER LLC NPI 1518609429

NPI Information

INDIANA RETINA CENTER LLC is a retina specialist ophthalmology in Fort Wayne, IN. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. INDIANA RETINA CENTER LLC NPI is 1518609429. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Indiana Retina Center.

The provider's business location address is:

7802 W JEFFERSON BLVD STE A
FORT WAYNE, IN
ZIP 46804-138
Phone: (410) 967-7322

The provider's authorized official is James Daeok Kim .
The authorized official title is President and has the following contact phone number (410) 967-7322.

The enumeration date for this NPI number is 4/11/2022 and was last updated on 8/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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