Organization
CITY OPTICAL CO., INC.
Active
Other names
Dr Tavel Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY S TAVEL MD (PRESIDENT)
(317) 924-1300
Entity
Organization
Contact information
Practice address
206 CONCORD MALL DR, ELKHART, IN 46517-3154
(574) 875-4499
(317) 924-3741
Mailing address
2839 LAFAYETTE ROAD, INDIANAPOLIS, IN 46222-2147
(317) 924-1300
(317) 924-3741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18002299
IN
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200156010A
—
IN
Enumeration date
10/20/2005
Last updated
05/07/2024
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