Individual
DR. GREY PRESTON BAALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
712 CAMERON WOODS DR, ANGOLA, IN 46703
(260) 668-3937
(260) 668-3794
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-9244
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002267
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092385
ANTHEM BCBS
IN
05
—
100225740
—
IN
01
—
P01201641
RAILROAD MEDICARE
IN
Enumeration date
05/24/2005
Last updated
08/14/2018
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