Individual
MATTHEW R DOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
901 E 86TH ST, INDIANAPOLIS, IN 46240-1807
(317) 844-5500
(317) 208-2248
Mailing address
901 E 86TH ST, INDIANAPOLIS, IN 46240-1807
(317) 844-5500
(317) 208-2248
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
107206
IA
152W00000X
Optometrist
Primary
18004373A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107206
STATE LICENSE
IA
05
—
300080058
—
IN
Enumeration date
01/25/2021
Last updated
02/21/2024
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