Organization
GROSSNICKLE EYE CENTER, INC.
Active
Other names
Grossnickle Eye Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA P GORDON (CFO; COO)
(574) 371-4685
Entity
Organization
Contact information
Practice address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 371-4697
Mailing address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 371-4697
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
50001530A
IN
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
50001530A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100274260A
—
IN
Enumeration date
03/07/2007
Last updated
03/03/2026
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