Organization
PLYMOUTH EYE CLINIC, P.C.
Active
Other names
Plymouth Family Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELSEY K BELL O.D. (OWNER (OPTOMETRIST))
(574) 935-3937
Entity
Organization
Contact information
Practice address
2878 MILLER DR, PLYMOUTH, IN 46563-8094
(574) 935-3937
(574) 936-4942
Mailing address
2878 MILLER DR, PLYMOUTH, IN 46563-8094
(574) 935-3937
(574) 936-4942
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002832
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000385395
ANTHEM
IN
05
—
200095640
—
IN
Enumeration date
12/05/2006
Last updated
09/22/2020
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