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Individual

DR. REX G TEEPLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1921 E. 53RD STREET, ANDERSON, IN 46013-4029
(765) 649-2278
(317) 259-8609
Mailing address
9795 CROSSPOINT BLVD, SUITE 100, INDIANAPOLIS, IN 46256-3354
(317) 254-6480
(317) 259-8609

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001679A
IN
152W00000X
Optometrist
18001679B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20091414970
IN
05
200914970B
IN
Enumeration date
12/06/2006
Last updated
09/03/2014
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