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Organization

OPHTHALMOLOGY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN C MANNIX M.D. (PRESIDENT OWNER)
(219) 362-6297
Entity
Organization

Contact information

Practice address
1300 STATE ST, STE. 1-F, LA PORTE, IN 46350-3185
(219) 362-6297
(219) 324-3061
Mailing address
1300 STATE ST, STE. 1F, LA PORTE, IN 46350-3185
(219) 362-6297
(219) 324-3061

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
207W00000X
Ophthalmology Physician

Other

Enumeration date
10/20/2006
Last updated
09/11/2025
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