Organization
RONALD FARY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD FARY O.D. (PRESIDENT)
(219) 743-3309
Entity
Organization
Contact information
Practice address
6608 KANSAS AVE, HAMMOND, IN 46323-1747
(219) 743-3309
Mailing address
6608 KANSAS AVE, HAMMOND, IN 46323-1747
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306292
ANTHEM
IN
05
—
200400220A
—
IN
Enumeration date
11/26/2013
Last updated
11/26/2013
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