Organization
HOOSIER EYE DOCTOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH V DE SPIRITO II O.D. (OWNER)
(812) 333-2020
Entity
Organization
Contact information
Practice address
1105 S COLLEGE MALL RD, BLOOMINGTON, IN 47401-6177
(812) 333-2020
(812) 333-2020
Mailing address
1105 S COLLEGE MALL RD, BLOOMINGTON, IN 47401-6177
(812) 333-2020
(812) 333-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003199A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200411980A
—
IN
Enumeration date
06/07/2010
Last updated
06/25/2010
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