Organization
DR. WILLIAM F. BRIGHAM, OPTOMETRIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F. BRIGHAM OD (PRESIDENT)
(260) 422-9421
Entity
Organization
Contact information
Practice address
902 W WAYNE ST, FORT WAYNE, IN 46802-3976
(260) 422-9421
(260) 422-9422
Mailing address
902 W WAYNE ST, FORT WAYNE, IN 46802-3976
(260) 422-9421
(260) 422-9422
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001470
IN
152WV0400X
Vision Therapy Optometrist
18001470
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100280170A
—
IN
01
—
13275
SPECTERA
—
05
—
200941810A
—
IN
01
—
IN1470
EYEMED
IN
Enumeration date
05/08/2008
Last updated
05/19/2011
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