Provider Demographics
NPI:1225276066
Name:ANDERSON LASER EYE CENTER
Entity Type:Organization
Organization Name:ANDERSON LASER EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
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:765-640-4791
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:765-640-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50005051A261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical