Organization
EYE ASSOCIATES OF SOUTHERN INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RONDA L BOMAN (INS SUPERVISOR)
(812) 258-4510
Entity
Organization
Contact information
Practice address
302 W 14TH ST, #100, JEFFERSONVILLE, IN 47130
(812) 284-0660
(812) 284-3822
Mailing address
302 W 14TH ST, #100, JEFFERSONVILLE, IN 47130
(812) 284-0660
(812) 284-3822
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200013830
—
IN
Enumeration date
11/09/2006
Last updated
04/26/2013
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