Organization
NORTHWEST INDIANA EYE & LASER CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A BUCK MD (PRESIDENT)
(219) 464-8223
Entity
Organization
Contact information
Practice address
851 EASTPORT CENTRE DR, VALPARAISO, IN 46383-2909
(219) 464-8223
(219) 531-2356
Mailing address
851 EASTPORT CENTRE DR, VALPARAISO, IN 46383-2909
(219) 464-8223
(219) 531-2356
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200343240A
—
IN
Enumeration date
11/17/2006
Last updated
11/20/2024
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