Organization
MADISON EYE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD A HAIDER DO (PRESIDENT)
(502) 883-1015
Entity
Organization
Contact information
Practice address
601 BROADWAY ST, MADISON, IN 47250-3362
(502) 883-1015
(502) 883-1019
Mailing address
2932 BRECKENRIDGE LN STE 5, LOUISVILLE, KY 40220-1490
(502) 371-9700
(502) 540-3070
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
02003914A
IN
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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