Organization
DOCTORS PARK EYECARE LLC
Active
Other names
MAX A HENRY MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX A HENRY MD (OWNER/MEDICAL DOCTOR)
(812) 372-4463
Entity
Organization
Contact information
Practice address
1930 DOCTORS PARK DR, COLUMBUS, IN 47203-2219
(812) 372-4463
(812) 372-2802
Mailing address
1930 DOCTORS PARK DR, COLUMBUS, IN 47203-2219
(812) 372-4463
(812) 372-2802
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01030454
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000826911
ANTHEM
—
01
—
1295755841
NPI
—
01
—
1730523119
GROUP NPI
—
05
—
200823550
—
IN
Enumeration date
04/29/2013
Last updated
04/24/2014
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