Individual
DR. NICHOLAS GLEN PHEBUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5406 W 38TH ST, INDIANAPOLIS, IN 46254-2918
(317) 280-8324
Mailing address
6553 N STATE ROAD 39, MULBERRY, IN 46058-9435
(765) 413-8768
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003920A
IN
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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