Individual
ERIC SKORUPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2001 REED RD, FORT WAYNE, IN 46815
(260) 426-5663
(260) 426-5693
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003907
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201294810
—
IN
01
—
P01684783
RAILROAD MEDICARE
IN
Enumeration date
06/24/2015
Last updated
08/15/2018
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