Organization
MATTINGLY CENTER FOR SIGHT LLC
Active
Other names
Mattingly Center for Sight
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PAUL MATTINGLY MD (OWNER-PHYSICIAN)
(765) 423-2977
Entity
Organization
Contact information
Practice address
1410 UNION ST, LAFAYETTE, IN 47904-2060
(765) 423-2977
(765) 423-1149
Mailing address
1410 UNION ST, LAFAYETTE, IN 47904-2060
(765) 423-2977
(765) 423-1149
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01026310A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086144
BCBS
IN
01
—
351654025
SAGAMORE HEALTH NETWORK
IN
Enumeration date
12/08/2006
Last updated
05/18/2016
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