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Organization
INDIANA RETINA CENTER LLC
Active
Organization
INDIANA RETINA CENTER LLC
Active
Other names
Indiana Retina Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DAEOK KIM MD (PRESIDENT)
(260) 305-2822
Entity
Organization
Contact information
Practice address
7802 W JEFFERSON BLVD STE A, FORT WAYNE, IN 46804-4138
(260) 305-2822
(260) 305-2829
Mailing address
7802 W JEFFERSON BLVD STE A, FORT WAYNE, IN 46804-4138
(260) 305-2822
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
NULL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
03/03/2026
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