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DANIEL O. ELLIOTT III OD NPI 1013187996


NPI Information

NPI: 1013187996
Provider Name: DANIEL O. ELLIOTT III OD
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
220 N IRONWOOD DR
SOUTH BEND, IN
ZIP 46615
Phone: (574) 233-3617
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DANIEL O. ELLIOTT III OD is an eyewear supplier in South Bend, IN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. DANIEL O. ELLIOTT III OD NPI is 1013187996. The provider is registered as an organization entity type.

The provider's business location address is:

220 N IRONWOOD DR
SOUTH BEND, IN
ZIP 46615-518
Phone: (574) 233-3617
Fax: (574) 280-7355

The provider's authorized official is Daniel O Elliott .
The authorized official title is Owner and has the following contact phone number (574) 233-3617.

The enumeration date for this NPI number is 3/6/2008 and was last updated on 7/21/2022.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear SupplierINDIANAYes

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
1100221940AMEDICAIDINDIANA

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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