Provider Demographics
NPI:1225027675
Name:DOI, STEVEN K (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:DOI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-2038
Mailing Address - Country:US
Mailing Address - Phone:765-675-4244
Mailing Address - Fax:765-675-8674
Practice Address - Street 1:415 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IN
Practice Address - Zip Code:46072-2038
Practice Address - Country:US
Practice Address - Phone:765-675-4244
Practice Address - Fax:765-675-8674
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001536A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100233580Medicaid
INT35056Medicare UPIN
INDO810370Medicare ID - Type Unspecified
IN100233580Medicaid