Organization
SURGERY CENTER OF EYE SPECIALISTS OF INDIANA, PC
Active
Other names
Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL LOUIS WALTON (CEO/ OWNER)
(317) 925-2200
Entity
Organization
Contact information
Practice address
1901 NORTH MERIDIAN STREET, INDIANAPOLIS, IN 46202
(317) 925-2200
(317) 921-6614
Mailing address
1901 NORTH MERIDIAN STREET, INDIANAPOLIS, IN 46202
(317) 925-2200
(317) 921-6614
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
50003654A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000098114
BLUE CROSS BLUE SHIELD
—
05
—
100103070A
—
IN
Enumeration date
10/17/2006
Last updated
08/30/2021
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