Organization
SOUTHSIDE EYE CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY ELMORE O.D. (PRESIDENT)
(317) 883-2020
Entity
Organization
Contact information
Practice address
1634 W SMITH VALLEY RD STE A, GREENWOOD, IN 46142-1550
(317) 883-2020
(317) 883-2059
Mailing address
1634 W SMITH VALLEY RD STE A, GREENWOOD, IN 46142-1550
(317) 883-2020
(317) 883-2059
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003454
IN
152WC0802X
Corneal and Contact Management Optometrist
18003454
IN
152WL0500X
Low Vision Rehabilitation Optometrist
18003454
IN
152WP0200X
Pediatric Optometrist
18003454
IN
152WV0400X
Vision Therapy Optometrist
18003454
IN
152WX0102X
Occupational Vision Optometrist
18003454
IN
Other
Enumeration date
10/06/2010
Last updated
03/20/2012
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