Individual
DR. JAMES L SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
220 N IRONWOOD DR, SOUTH BEND, IN 46615-2518
(574) 234-8251
(574) 280-7355
Mailing address
220 N IRONWOOD DR, SOUTH BEND, IN 46615-2518
(574) 234-8251
(574) 280-7355
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001482A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100150080A
—
IN
Enumeration date
08/12/2005
Last updated
09/03/2010
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