Organization
DANVILLE FAMILY EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEELY DOREEN ALLEN O.D. (OPTOMETRIST)
(812) 249-0100
Entity
Organization
Contact information
Practice address
95 N TENNESSEE ST, DANVILLE, IN 46122-1223
(317) 699-2000
Mailing address
95 N TENNESSEE ST, DANVILLE, IN 46122-1223
(317) 699-2000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003426A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490514
ANTHEM PIN
IN
05
—
200854310
—
IN
01
—
P00371968
MEDICARE RAILROAD
IN
Enumeration date
08/17/2015
Last updated
02/24/2016
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