Individual
DR. KREGG C KOONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD OPTOMETRY
Contact information
Practice address
3300 W FOX RIDGE LN, MUNCIE, IN 47304-5201
(765) 289-4727
(765) 751-2207
Mailing address
205 S BUCKINGHAM RD, YORKTOWN, IN 47396-9253
(765) 722-0140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18002701B
IN
152W00000X
Optometrist
Primary
2701
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100376600
—
IN
Enumeration date
08/16/2006
Last updated
08/27/2015
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