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Individual

DR. CHARLES DIRK TITUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
980 AVERITT RD, GREENWOOD, IN 46143-9540
(317) 881-4143
(317) 881-5072
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
18001973
IN
152W00000X
Optometrist
Primary
18001973A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000091935
ANTHEM BCBS
IN
01
0503450001
DURABLE MEDICAL EQUIPMENT
IN
05
100193940A
IN
01
410032688
RAILROAD MEDICARE
IN
01
5895547
AETNA USHC
IN
01
IN1973
EYEMED VISION CARE
IN
01
NA
VISION SERVICE PLAN
IN
01
T88595
UPIN
IN
Enumeration date
09/13/2005
Last updated
04/04/2022
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