Provider Demographics
NPI:1962550095
Name:BURNS, BRUCE HINKLE (OD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:HINKLE
Last Name:BURNS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 OAKLANDON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9543
Mailing Address - Country:US
Mailing Address - Phone:317-823-9985
Mailing Address - Fax:317-823-9984
Practice Address - Street 1:8170 OAKLANDON RD
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9543
Practice Address - Country:US
Practice Address - Phone:317-823-9985
Practice Address - Fax:317-823-9984
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001867A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU25092Medicare UPIN
INM400018673Medicare PIN