Organization
CITY OPTICAL CO., INC.
Active
Other names
Dr. Tavel Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA D SPENCER (CREDENTIALING COORDINATOR)
(317) 924-1300
Entity
Organization
Contact information
Practice address
466 S INDIANA ST, MOORESVILLE, IN 46158-1710
(317) 271-7296
(855) 326-4293
Mailing address
2839 LAFAYETTE RD, INDIANAPOLIS, IN 46222-2147
(317) 924-1300
(855) 326-4293
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197360
MEDICARE
IN
05
—
300049976
—
IN
Enumeration date
03/26/2021
Last updated
10/27/2021
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