Organization
FEWELL EYE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R MICHAEL FEWELL O.D. (OWNER)
(765) 455-0404
Entity
Organization
Contact information
Practice address
3421 S LAFOUNTAIN ST, SUITE A, KOKOMO, IN 46902-3852
(765) 455-0404
(765) 455-1765
Mailing address
PO BOX 2767, KOKOMO, IN 46904-2767
(765) 455-0404
(765) 455-1765
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001678B
IN
Other
Enumeration date
03/20/2007
Last updated
01/15/2009
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