Individual
DR. JEFFREY D. IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
634 CROSS VALLEY CIR, EVANSVILLE, IN 47710-5238
(812) 401-7777
(812) 429-0392
Mailing address
RR 2 BOX 566, HAUBSTADT, IN 47639-9501
(812) 768-6523
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003164
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200394550
—
IN
01
—
4484690001
DMEPOS
IN
01
—
P00928487
RAILROAD MEDICARE
IN
Enumeration date
08/25/2006
Last updated
06/30/2011
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