Individual
KELLEY LYNN DEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1980 N NATIONAL RD STE 300, COLUMBUS, IN 47201-4505
(317) 202-1438
(317) 202-1280
Mailing address
1980 N NATIONAL RD STE 300, COLUMBUS, IN 47201-4505
(317) 202-1438
(317) 202-1280
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002969A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201006850
—
IN
01
—
A00845
EYEMED
IN
Enumeration date
09/11/2006
Last updated
02/10/2026
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