GRANGER RETINA CENTER PC NPI 1346155611

NPI Information

  • NPI: 1346155611
  • Provider Name: GRANGER RETINA CENTER PC
  • Classification: Ophthalmology - 207WX0107X
  • Specialization: Retina Specialist
  • Entity Type: Organization
  • Address: 2288 BANYAN HILL CT
    FORT WAYNE, IN
    ZIP 46814
  • Phone: (225) 573-9954

Map and Directions

Get Directions

NPI Details

GRANGER RETINA CENTER PC is a retina specialist ophthalmology in Fort Wayne, IN. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. GRANGER RETINA CENTER PC NPI is 1346155611. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2288 BANYAN HILL CT
FORT WAYNE, IN
ZIP 46814-590
Phone: (225) 573-9954

The provider's authorized official is Jason Min So .
The authorized official title is President and has the following contact phone number (225) 573-9954.

The enumeration date for this NPI number is 8/19/2026 and was last updated on 8/19/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207WX0107XOphthalmologyRetina SpecialistYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.