Organization
VANARSDALL FAMILY OPTOMETRY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEN LYNN VANARSDALL O.D. (OWNER / PRESIDENT)
(812) 376-3068
Entity
Organization
Contact information
Practice address
1033 JACKSON ST STE C, COLUMBUS, IN 47201-5769
(812) 376-3068
(812) 376-6771
Mailing address
1033 JACKSON ST STE C, COLUMBUS, IN 47201-5769
(812) 376-3068
(812) 376-6771
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
56000172A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100083400A
—
IN
01
—
22000000103899
ANTHEM
IN
01
—
56000172A
LICENSE REGISTRATION NUM
IN
Enumeration date
08/29/2006
Last updated
04/30/2010
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