Provider Demographics
NPI:1043397581
Name:ANDERSON CENTER FOR SIGHT
Entity Type:Organization
Organization Name:ANDERSON CENTER FOR SIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:WOSCHITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-644-1225
Mailing Address - Street 1:1931 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-4206
Mailing Address - Country:US
Mailing Address - Phone:765-644-1225
Mailing Address - Fax:765-644-1447
Practice Address - Street 1:1931 BROWN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-4206
Practice Address - Country:US
Practice Address - Phone:765-644-1225
Practice Address - Fax:765-644-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50003824A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN509850Medicare ID - Type Unspecified