Provider Demographics
NPI:1811049901
Name:MEYER AND ASSOCIATES OPTOMETRY, PC
Entity type:Organization
Organization Name:MEYER AND ASSOCIATES OPTOMETRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:DANA
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-773-4482
Mailing Address - Street 1:160 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1307
Mailing Address - Country:US
Mailing Address - Phone:317-773-4482
Mailing Address - Fax:317-776-2520
Practice Address - Street 1:160 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1307
Practice Address - Country:US
Practice Address - Phone:317-773-4482
Practice Address - Fax:317-770-3796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001746A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5587880001Medicare NSC
IN232710Medicare PIN