Provider Demographics
NPI:1043345820
Name:DRS BORISH BURKHART & REID INC
Entity Type:Organization
Organization Name:DRS BORISH BURKHART & REID INC
Other - Org Name:DRS. CALVIN AND BURKHART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:765-453-2907
Mailing Address - Street 1:511 W LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3481
Mailing Address - Country:US
Mailing Address - Phone:765-453-2907
Mailing Address - Fax:765-453-6111
Practice Address - Street 1:511 W LINCOLN RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3481
Practice Address - Country:US
Practice Address - Phone:765-453-2907
Practice Address - Fax:765-453-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN56000005A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100135900AMedicaid
IN0167790001Medicare NSC
IN100135900AMedicaid