Provider Demographics
NPI:1013015429
Name:VISIONQUEST EYECARE PC
Entity Type:Organization
Organization Name:VISIONQUEST EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-501-3103
Mailing Address - Street 1:1160 N STATE ROAD 135 STE A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1019
Mailing Address - Country:US
Mailing Address - Phone:317-865-6829
Mailing Address - Fax:317-886-7655
Practice Address - Street 1:1160 N STATE ROAD 135 STE A
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1019
Practice Address - Country:US
Practice Address - Phone:317-865-6829
Practice Address - Fax:317-886-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002112152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN675840Medicare ID - Type Unspecified
IN1205720003Medicare NSC
IN1205720002Medicare NSC