Organization
JIM I SOWDERS OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM I SOWDERS OD (PRESIDENT)
(812) 275-6155
Entity
Organization
Contact information
Practice address
1615 O ST, BEDFORD, IN 47421-4116
(812) 275-6155
(812) 278-9405
Mailing address
1615 O ST, BEDFORD, IN 47421-4116
(812) 275-6155
(812) 278-9405
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002066A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000223127
ANTHEM
IN
05
—
100166710A
—
IN
Enumeration date
05/25/2007
Last updated
02/14/2017
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