Provider Demographics
NPI:1083456545
Name:PARKS, CAITLIN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:MARIE
Last Name:PARKS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10588 E 200 N
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:IN
Mailing Address - Zip Code:46069-9042
Mailing Address - Country:US
Mailing Address - Phone:317-601-6087
Mailing Address - Fax:
Practice Address - Street 1:1451 JASON RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1039
Practice Address - Country:US
Practice Address - Phone:317-462-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004497A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist