Individual
DR. WILLIAM R FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2500 E MARKET ST, LOGANSPORT, IN 46947
(574) 753-3583
(574) 722-2364
Mailing address
2500 E MARKET ST, P. O. BOX 597, LOGANSPORT, IN 46947-2011
(574) 722-5252
(574) 722-3202
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001775A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100070660
—
IN
Enumeration date
05/15/2006
Last updated
08/15/2018
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