| NPI | 1073671731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN R BAXTER Owner/Ophthalmologist 574-271-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 152W00000X Optometrist | |
| 174400000X Specialist | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2018-06-18 |