Organization
NEWBURGH EYE CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A GILLES O.D. (OPTOMETRIST)
(812) 853-8191
Entity
Organization
Contact information
Practice address
8688 RUFFIAN LN, SUITE B, NEWBURGH, IN 47630-3411
(812) 853-8191
Mailing address
8688 RUFFIAN LN, SUITE B, NEWBURGH, IN 47630-3411
(812) 853-8191
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
18002239
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089373
ANTHEM BCBS
IN
01
—
GI161240
CLARITY VISION
IN
Enumeration date
07/02/2008
Last updated
07/02/2008
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