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GREATER LAFAYETTE RETINA CENTER P.C. NPI 1629280813


NPI Information

NPI: 1629280813
Provider Name: GREATER LAFAYETTE RETINA CENTER, P.C.
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
1013 N 13TH ST
LAFAYETTE, IN
ZIP 47904
Phone: (765) 428-8888
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GREATER LAFAYETTE RETINA CENTER, P.C. is an ophthalmology in Lafayette, IN. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. GREATER LAFAYETTE RETINA CENTER, P.C. NPI is 1629280813. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1013 N 13TH ST
LAFAYETTE, IN
ZIP 47904-011
Phone: (765) 428-8888
Fax: (765) 428-8889

The provider's authorized official is Phyllis M. Watkins .
The authorized official title is Billing Department and has the following contact phone number (765) 428-8888.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 6/27/2014.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmology01057576AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H91897MEDICARE UPININDIANA
201057576AOTHERINDIANASTATE LICENSE
3=========OTHERINDIANAEMPLOYER ID
4POO176469OTHERINDIANARAILROAD MEDICARE
5219490MEDICARE ID-TYPE UNSPECIFIEDINDIANA
6200441070MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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