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Individual

DR. BRADLEY ALEXANDER HIATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004187A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2067
SC
Enumeration date
06/06/2018
Last updated
01/06/2023
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