Provider Demographics
NPI:1154691335
Name:DRS. LAUCK AND MCLEAN
Entity type:Organization
Organization Name:DRS. LAUCK AND MCLEAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-848-9081
Mailing Address - Street 1:30 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2102
Mailing Address - Country:US
Mailing Address - Phone:317-848-9081
Mailing Address - Fax:317-848-9083
Practice Address - Street 1:30 1ST ST SW
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2102
Practice Address - Country:US
Practice Address - Phone:317-848-9081
Practice Address - Fax:317-848-9083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003121B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty