Organization
COMPREHENSIVE EYE CARE OF INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE ELLIOTT MCCORD M.D. (PRESIDENT)
(317) 845-1305
Entity
Organization
Contact information
Practice address
7301 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2085
(317) 845-1305
(317) 842-3621
Mailing address
6418 LANDBOROUGH SOUTH DR, INDIANAPOLIS, IN 46220-4357
(317) 845-1305
(317) 842-3621
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
50003808A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000104148
ANTHEM BLUE NETWORK
IN
01
—
317426300
TRICARE CHAMPUS
—
Enumeration date
08/19/2006
Last updated
09/13/2012
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