Organization
EYE CENTER GROUP LLC
Active
Other names
Fort Wayne Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY S RAPKIN (PART OWNER)
(765) 286-8888
Entity
Organization
Contact information
Practice address
321 E WAYNE ST, FORT WAYNE, IN 46802-2713
(260) 424-5656
(260) 424-4511
Mailing address
PO BOX 457, RICHMOND, IN 47375-0457
(765) 966-7345
(765) 966-2975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100256600J
—
IN
05
—
2858064
—
OH
Enumeration date
01/05/2007
Last updated
03/12/2009
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